DR. JENNY LILES (NPI# 1124552690) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124552690 |
| Entity Type | Individual |
| Full Name | DR. JENNY LILES |
| Credential | M.D. |
| Practice Address |
1004 Chafee Ave Augusta GA 30904 |
| Mailing Address |
1004 Chafee Ave Augusta GA 30904-5810 |
| Practice Telephone | 7067216231 |
| Mailing Telephone | 7067216231 |
| Enumeration Date | 2017-04-11 |
| Last Update Date | 2018-06-18 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 920 Madison Ave, Suite 447, Memphis, TN 381033438 | 9014485814 |
| Street Address |
1004 CHAFEE AVE |
| City | AUGUSTA |
| State | GA |
| Zip Code | 30904 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720516560 | James Petit | Dermatology | 1004 Chafee Ave, Augusta, GA 30904 | 2017-05-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518423706 | Lawren Murray Tachias | Registered Nurse | 950 15th Street Downtown, Augusta, GA 30904 | 2019-02-13 |
| 1457851842 | Heba Ahmed | Pharmacist | 912 15th Street, Augusta, GA 30904 | 2018-02-13 |
| 1932640836 | Claudia Crawford | Student in an Organized Health Care Education/Training Program | 2624 Oakland Ave., Augusta, GA 30904 | 2017-03-13 |
| 1801240528 | F. Marion Durst IIi Dmd PC | Clinic/Center | 2325 Washington Road, Augusta, GA 30904 | 2016-04-19 |
| 1689031296 | Teresa Maria Martin | Counselor | 1e-148, Charlie Norwood Vamc One Freedom Way, Augusta, GA 30904 | 2016-01-27 |
| 1598122269 | Jillian Wilkerson | Counselor | Charlie Norwood Veteran Affairs One Freedom Way, Substance Use Recovery Clinic, Augusta, GA 30904 | 2016-01-26 |
| 1760855241 | Chase King | Occupational Therapist | 1735 Berkeley Rd, Augusta, GA 30904 | 2015-11-05 |
| 1962832246 | April Underwood Fox | Physician Assistant | 1417 Pendleton Rd, Augusta, GA 30904 | 2013-11-22 |
| 1861734378 | John Graham Theisen | Obstetrics & Gynecology | 810 Chafee Avenue, Augusta, GA 30904 | 2013-03-22 |
| 1396012852 | Servicorp Resource Center, Inc. | Psychologist | 1904 Highland Avenue, Augusta, GA 30904 | 2011-11-28 |
| Find all providers in zip 30904 | ||||
| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336764851 | Joseph Pansius | Student in an Organized Health Care Education/Training Program | 1465 Laney Walker Blvd Bldg Af-1040, Augusta, GA 30912-0002 | 2020-06-10 |
| 1093339517 | Daniel Jason Garcia | Student in an Organized Health Care Education/Training Program | 1040 Alexander Dr Apt 6323, Augusta, GA 30909-0291 | 2020-06-01 |
| 1922633643 | Miki Christine Hayashi | Student in an Organized Health Care Education/Training Program | 1120 15th Street Augusta, Augusta, GA 30912-0001 | 2020-03-03 |
| 1578195277 | Joseph Nelson Eddy | Student in an Organized Health Care Education/Training Program | 430 John Wesley Gilbert Drive, Augusta, GA 30912-0001 | 2020-02-10 |
| 1669035960 | Katherine Arenella | Student in an Organized Health Care Education/Training Program | 1 Freedom Way # 21, Augusta, GA 30904-6258 | 2019-04-22 |
| 1881257152 | Walker Barmore | Student in an Organized Health Care Education/Training Program | Augusta University 1120 15th St Bi5070, Augusta, GA 30912-0001 | 2019-04-22 |
| 1255892253 | Jennifer Bates | Student in an Organized Health Care Education/Training Program | 1120 15th St # Gc5119, Augusta, GA 30912-0004 | 2019-03-31 |
| 1861950768 | Ila Steinke | Student in an Organized Health Care Education/Training Program | S9259 County Road V, Augusta, WI 54722 | 2019-03-09 |
| 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 |
| 1609334820 | Ashley Alexandra Pater | Student in an Organized Health Care Education/Training Program | Augusta University 1120 15th Street Gc 5110, Augusta, GA 30912-0001 | 2019-03-06 |
| Find all providers in AUGUSTA | ||||
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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.