MR. CLINT R. FENTON (NPI# 1093205957) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093205957 |
| Entity Type | Individual |
| Full Name | MR. CLINT R. FENTON |
| Credential | PA |
| Practice Address |
11700 Mercy Blvd Plaza D #6 Savannah GA 31419 |
| Mailing Address |
836 E. 65th Street Suite 20 Savannah GA 31405 |
| Practice Telephone | 9129273434 |
| Practice Fax Number | 9129210982 |
| Mailing Telephone | 9128197878 |
| Mailing Fax Number | 9128193555 |
| Enumeration Date | 2018-05-16 |
| Last Update Date | 2019-04-23 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | GA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
11700 MERCY BLVD PLAZA D #6 |
| City | SAVANNAH |
| State | GA |
| Zip Code | 31419 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215932066 | Cynthia Drown | Nurse Practitioner | 11700 Mercy Blvd, Plaza D Suite A, Savannah, GA 31419-1753 | 2005-06-17 |
| 1568962967 | Ortho Sport & Spine Physicians Savannah | Clinic/Center | 11700 Mercy Blvd, Savannah, GA 31419-1753 | 2018-02-13 |
| 1982134003 | Mackenzie Grace Shelton | Physician Assistant | 11700 Mercy Blvd, Plaza D #6, Savannah, GA 31419 | 2017-06-13 |
| 1205383130 | Beverly J Lippert | Nurse Practitioner | 11700 Mercy Blvd, Plaza D #6, Savannah, GA 31419 | 2016-09-08 |
| 1487000519 | Angel Everidge | Physician Assistant | 11700 Mercy Blvd, Plaza D, #6, Savannah, GA 31419 | 2016-05-07 |
| 1629470273 | Ortho Sport & Spine Physicians Savannah | Orthopaedic Surgery | 11700 Mercy Blvd, Savannah, GA 31419-1753 | 2014-09-25 |
| 1568805505 | Andrew Robert Papoy | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 11700 Mercy Blvd, Plaza D Bldg. 1 Suite A, Savannah, GA 31419 | 2013-04-09 |
| 1750635579 | St. Joseph's Medical Group, LLC | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 11700 Mercy Blvd, Plaza D Suite A, Savannah, GA 31419 | 2012-10-31 |
| 1407119423 | Rebecca M Hart | Nurse Practitioner | 11700 Mercy Blvd, Bldg #5, Savannah, GA 31419-1753 | 2012-06-25 |
| 1053681155 | Southeast Lung & Critical Care Specialists, PC | Internal Medicine | 11700 Mercy Blvd, Bldg #5, Savannah, GA 31419-1753 | 2012-01-05 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255932653 | Loving Hands Adult Care | Home Health Aide | 101 St. Goerge Blvd, 6t, Savannah, GA 31419 | 2020-11-03 |
| 1285241265 | Jennifer Ann Hales | Surgery | 11090 Mcauley, Suite 100 2a, Savannah, GA 31419 | 2020-09-24 |
| 1699318139 | Jessica Kaitlyn Matthewson | Nurse Practitioner | 11700 Mercy Blvd Plaza D, Bldg #5, Savannah, GA 31419 | 2019-10-28 |
| 1679133219 | Rebecca Denise Brown-tuyishimire | Counselor | Savannah Outpatient Clinic, 1170 Shawnee Street, Savannah, GA 31419 | 2019-06-17 |
| 1356900856 | Julio Roberto Castellanos Jr. | Behavior Technician | 785 King George Blvd Ste 103, Savannah, GA 31419 | 2019-06-07 |
| 1669941761 | Paul-david Arthur Cooper | Peer Specialist | 117 Shawnee Street, Va Savannah Clinic, Savannah, GA 31419 | 2018-11-19 |
| 1326538521 | Jay Carter Jr. | Social Worker | 1170 Shawnee St., Savannah, GA 31419 | 2018-05-14 |
| 1245771070 | Emily Robertson | Nurse Practitioner | 11133 Abercorm Street, Suite 10, Savannah, GA 31419 | 2017-03-13 |
| 1760833750 | Cady-jo Steidle | Behavioral Analyst | 143 Sugar Mill Cir, Savannah, GA 31419 | 2016-06-30 |
| 1265881189 | Mallory Williams | Physician Assistant | 11909 D. Mcauley Drive, Savannah, GA 31419 | 2016-06-10 |
| Find all providers in zip 31419 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306476965 | Alyssa Joyce Trenaman | Physician Assistant | 216 Lyman Hall, Savannah, GA 31410-1045 | 2020-01-23 |
| 1407311012 | Kia Elon Burch | Physician Assistant | 1004 Memorial Ln Ste 200, Savannah, GA 31410-1255 | 2019-02-07 |
| 1316430978 | Dawn Obrien | Physician Assistant | 4717 Hwy 80 E Ste H-1, Savannah, GA 31410-2943 | 2018-06-08 |
| 1265881189 | Mallory Williams | Physician Assistant | 11909 D. Mcauley Drive, Savannah, GA 31419 | 2016-06-10 |
| 1659727634 | Andrea L Yates | Physician Assistant | 10 Country Club Dr, Savannah, GA 31410-3406 | 2016-05-10 |
| 1861878233 | Roksana Grozeva | Physician Assistant | 900 Mohawk St Ste A, Savannah, GA 31419-1772 | 2015-08-07 |
| 1053791434 | Robert Earnest Sikes Jr. | Physician Assistant | 112 Steeplechase Rd, Savannah, GA 31405-1049 | 2015-06-01 |
| 1497160121 | Meredith Grace Lenichek | Physician Assistant | 4717 Us Highway 80 E, Savannah, GA 31410-2943 | 2014-06-20 |
| 1215364120 | Zachary K Johannesen | Physician Assistant | 5353 Reynolds Reynolds Street, Savannah, GA 31405-6015 | 2013-10-09 |
| 1588003651 | Brittany R. Tice | Physician Assistant | 509 Foundation Dr, Savannah, GA 31408-2215 | 2013-06-21 |
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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.