MRS. KIRBY BROWN REINECKE (NPI# 1093047474) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093047474 |
| Entity Type | Individual |
| Full Name | MRS. KIRBY BROWN REINECKE |
| Credential | PA-C |
| Practice Address |
120 Oakside Ct Suite H Canton GA 30114-2471 |
| Practice Telephone | 6788808770 |
| Practice Fax Number | 7702134418 |
| Mailing Telephone | 6788808770 |
| Mailing Fax Number | 7702134418 |
| Enumeration Date | 2010-02-09 |
| Last Update Date | 2016-09-29 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
5775 | GA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
120 OAKSIDE CT SUITE H |
| City | CANTON |
| State | GA |
| Zip Code | 30114-2471 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750764932 | Kathleen Davis | Registered Nurse | 120 Oakside Ct, Canton, GA 30114-2471 | 2015-07-07 |
| 1952716136 | Tami Mccoy | Nurse Practitioner | 120 Oakside Ct, Canton, GA 30114-2471 | 2014-06-25 |
| 1508188558 | Georgia Mountain Endocrinology Corporation | Internal Medicine | 120 Oakside Ct, Suite H, Canton, GA 30114-2471 | 2010-02-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619516093 | Wickshire Canton Opco LLC | Assisted Living Facility | 125 Riverstone Terrace, Canton, GA 30114 | 2020-01-02 |
| 1154803583 | Alixandra Nicole Flournoy | Physical Therapist | 131 Holly Street, Canton, GA 30114 | 2018-09-01 |
| 1588157341 | Provident Group - Canton Cove Properties LLC | Alzheimer Center (Dementia Center) | 1100 Reinhardt College Parkway, Canton, GA 30114 | 2018-06-07 |
| 1003233107 | Heartland Dental Care of Georgia | Dentist | 3237 Sixes Rd, Canton, GA 30114 | 2014-03-26 |
| 1730510959 | Joseph Optical | Eyewear Supplier (Equipment, not the service) | 1455 Riverstone Pkwy Suite 110, Canton, GA 30114 | 2013-12-13 |
| 1629313036 | Ramona Morton Rasmussen | Occupational Therapist | 200 Riverstone Drive, Suite B, Canton, GA 30114 | 2012-12-11 |
| 1902154875 | Yong Qiao Luo | Acupuncturist | 200 Oakside Lane, Suite D, Canton, GA 30114 | 2012-08-26 |
| 1215294350 | Christina Lynn Hernandez | Pediatrics | 1558 Riverstone Pkwy Ste 100, Canton, GA 30114 | 2012-04-13 |
| 1558638981 | Stephen E Byrd | Counselor | 191 Lamar Haley Pkwy., Canton, GA 30114 | 2011-11-30 |
| 1073807855 | Sheri Sullins Buckley | Nurse Practitioner | 120 Oakside Ct Ste H, Canton, GA 30114 | 2011-06-08 |
| Find all providers in zip 30114 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326525270 | Kylie Broughal | Physician Assistant | 6119 St Hwy Rt 11, St Lawrence Medical Office Complex, Canton, NY 13617 | 2018-07-24 |
| 1740684083 | Nemi Thakker | Physician Assistant | 1351 Centennial Ct, Canton, MI 48187-5805 | 2014-10-15 |
| 1578784013 | Aimee M Mitchell | Physician Assistant | 130 Oakside Court, Ste A Marietta Dermatology Associates Pa, Canton, GA 30114 | 2007-05-01 |
| 1447390315 | Morgan P Bowler | Physician Assistant | 460 Northside Cherokee Blvd Ste 450, Canton, GA 30115-8020 | 2007-02-08 |
| 1821052440 | James Willard Gilson | Physician Assistant | 6200 N Haggerty Rd, Canton, MI 48187 | 2006-04-12 |
| 1134188105 | Eddy Toussaint | Physician Assistant | 460 Northside Cherokee Blvd Ste 100, Canton, GA 30115-8017 | 2006-03-20 |
| 1255330098 | Stephen P Hinman | Physician Assistant | 205 State Street Road, Canton, NY 13617 | 2005-07-14 |
| 1467458612 | Barbara Jo Bizub | Physician Assistant | 4535 Dressler Rd Nw, Canton, OH 44718-2545 | 2005-06-22 |
| 1518521145 | Gabriel Martin Ibarra | Physician Assistant | 112 Southlake Cir, Canton, MS 39046-5368 | 2019-04-29 |
| 1962921643 | Cameron Hord | Physician Assistant | 5154 Fulton Dr Nw, Canton, OH 44718-2365 | 2017-09-14 |
| Find all providers in CANTON | ||||
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| 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.