MR. KEITH F. O'MALLEY


Address: 1120 15th St, Augusta, GA 30912-0004
Phone: 7067213671

MR. KEITH F. O'MALLEY (NPI# 1053381145) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1053381145
Entity Type Individual
Full Name MR. KEITH F. O'MALLEY
Credential M.D.
Practice Address 1120 15th St
Augusta
GA 30912-0004
Mailing Address 1499 Walton Way
Ste 1400
Augusta
GA 30901-2602
Practice Telephone 7067213671
Mailing Telephone 7068288401
Enumeration Date 2006-01-23
Last Update Date 2014-06-16
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 2086S0127X Surgery
Specialization: Trauma Surgery
65039 GA Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
NJ 1869507 05

Office Location

Street Address 1120 15TH ST
City AUGUSTA
State GA
Zip Code 30912-0004

Providers in the same location

NPI Name Taxonomy Address Enumeration
1427051556 Gyanendra Kumar Sharma Internal Medicine 1120 15th St, Augusta, GA 30912-0004 2005-05-23
1912508532 Lacey Nichol Preston Physician Assistant 1120 15th St, Augusta, GA 30912-0004 2020-11-02
1992302988 Victoria Mae Pregibon Physician Assistant 1120 15th St, Augusta, GA 30912-0004 2020-10-03
1275130239 Tanya Renee Hall Nurse Practitioner 1120 15th St, Augusta, GA 30912-0004 2020-10-02
1144847864 Cassandra Marie Voong Internal Medicine 1120 15th St, Augusta, GA 30912-0004 2020-06-29
1245857002 Morgan Rowe Nurse Practitioner 1120 15th St, Augusta, GA 30912-0004 2020-06-28
1639795990 Lauren Christine Bush Audiologist 1120 15th St, Augusta, GA 30912-0004 2020-06-23
1811513575 Ashley Danielle Fox Internal Medicine 1120 15th St, Augusta, GA 30912-0006 2020-06-18
1265058994 Matthew Craddock Psychiatry & Neurology 1120 15th St, Augusta, GA 30912-0004 2020-06-18
1437775301 Joseph John Arellano Emergency Medicine 1120 15th St, Augusta, GA 30912-0004 2020-06-17
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1548885940 Hannah Gullickson Folsom Family Medicine 1459 Laney Walker Blvd Ae 3042, Augusta, GA 30912 2020-06-11
1487278909 Robert Kennedy Internal Medicine Augusta University Internal Medicine Residency Program, 1120 15th Street, Bi 5070, Augusta, GA 30912 2020-06-01
1952968737 Kayla M. Lasota Pediatrics 11230 115th St Ae3042, Augusta, GA 30912 2019-05-28
1003379280 Kayla Cox Internal Medicine 1120 15th St Bi5070, Augusta, GA 30912 2019-04-13
1619435740 Justin Ray Mackert Student in an Organized Health Care Education/Training Program Augusta University, 1120 15th Street, Gc 5110, Augusta, GA 30912 2019-03-07
1417444167 Victor Celis Dentist John Wesley Gilbert Dr, Augusta, GA 30912 2018-04-18
1487157921 Julie Ann Matsen Student in an Organized Health Care Education/Training Program 997 St. Sebastian Way, Eg-2021-10, Augusta Univ., Dept. of Psychiatry & Health Behavior, Augusta, GA 30912 2018-03-12
1497287031 Luke Yuung-jier Chang Ophthalmology 1120 15th St # Ba2720, Augusta, GA 30912 2017-04-02
1821537622 Lashawn Kay Boone Nurse Practitioner 1445 Harper St, Augusta, GA 30912 2017-02-14
1134675564 Arnab Saha Internal Medicine 1120 15 Th St., Augusta, GA 30912 2016-08-26
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Taxonomy Information

Taxonomy Code 2086S0127X
Grouping Allopathic & Osteopathic Physicians
Classification Surgery
Specialization Trauma Surgery

Taxonomy Definition

Trauma surgery is a recognized subspecialty of general surgery. Trauma surgeons are physicians who have completed a five-year general surgery residency and usually continue with a one to two year fellowship in trauma and/or surgical critical care, typically leading to additional board certification in surgical critical care. There is no trauma surgery board certification at this point. To obtain board certification in surgical critical care, a fellowship in surgical critical care or anesthesiology critical care must be completed during or after general surgery residency.
Notes: Source: American Board of Surgery, 2007 [1/1/2008: definition added, source added] Additional Resources: http://www.absurgery.org/.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1245456706 Cassandra Quiana White Surgery 1120 15th St, Augusta, GA 30912-0004 2007-04-17
1194854091 Ian Russell Driscoll Surgery 1416 Wainbrook Dr, Augusta, GA 30909-6289 2007-03-05
1083724454 Michael L. Hawkins Surgery 1120 15th St, Augusta, GA 30912-0004 2006-08-30

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1205192424 Nathan John Klingensmith Surgery 69 Jesse Hill Jr Drive, Se, Glenn Memorial Building, 3rd Floor, Atlanta, GA 30303 2012-04-03
1306928809 Kevin J Farrell Surgery 101 West Ponce Deleon Ave, Emory Medical Care Foundation Ste 331, Decatur, GA 30030 2006-10-20
1972503837 Gregory R Strauther Surgery 200 S Enota Dr Ne, Suite 150, Gainesville, GA 30501-3473 2005-07-21
1841583119 Brian H Gibson Surgery 743 Spring St Ne, Gainesville, GA 30501-3715 2011-05-19
1699065573 Wellstar Medical Group, LLC Surgery 55 Whitcher St Ne, Suite 130, Marietta, GA 30060-1156 2011-04-13
1710283460 Malcolm Ingram Goodchild Surgery 2737 Warm Springs Rd, Building A, Columbus, GA 31904-6859 2011-01-28
1215248604 James G Boron Surgery 55 Whitcher St Ne Ste 130, Marietta, GA 30060 2010-06-30
1427377043 James Clifton Haynes Surgery 2500 Hospital Blvd Ste 290, Roswell, GA 30076-4918 2010-05-21
1700047784 Keren Aviva Bashan-gilzenrat Surgery 55 Whitcher St Ne Ste 130, Marietta, GA 30060 2008-06-22
1790946762 Katherine Kohler Surgery 69 Jesse Hill Jr Dr Se, Atlanta, GA 30303-3033 2008-06-22
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Competitor

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City AUGUSTA
Zip Code 30912

Improve Information

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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