DR. LUCERO JACQUELINE VIVAR (NPI# 1134533961) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134533961 |
| Entity Type | Individual |
| Full Name | DR. LUCERO JACQUELINE VIVAR |
| Credential | M.D. |
| Practice Address |
3121 Peach Orchard Rd Augusta GA 30906-3521 |
| Mailing Address |
Po Box 52 Charleston SC 29402 |
| Practice Telephone | 7068631440 |
| Enumeration Date | 2014-06-19 |
| Last Update Date | 2018-03-17 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | 78471 | GA | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | TRN20091 | FL | Student, Health Care |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1600 Sw Archer Rd, B100296, Gainesville, FL 326100296 | 3522738234 |
| Street Address |
3121 PEACH ORCHARD RD |
| City | AUGUSTA |
| State | GA |
| Zip Code | 30906-3521 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649241902 | Sheng Y Wang | Internal Medicine | 3121 Peach Orchard Rd, Suite 103, Augusta, GA 30906-3521 | 2006-01-26 |
| 1487271318 | Wendel Mcmillan | Licensed Practical Nurse | 3121 Peach Orchard Rd, Augusta, GA 30906-3521 | 2020-06-26 |
| 1285093443 | Lindsey Joanne Meagher | Nurse Practitioner | 3121 Peach Orchard Rd, Augusta, GA 30906-3521 | 2016-02-16 |
| 1265879761 | Tranika C Brown | Nurse Practitioner | 3121 Peach Orchard Rd, #103, Augusta, GA 30906-3521 | 2013-05-24 |
| 1023310182 | Wouter Johan Ceyssens | Physician Assistant | 3121 Peach Orchard Rd, Suite 102, Augusta, GA 30906-3521 | 2010-11-23 |
| 1841500543 | Natasha Lindsey Nattier | Nurse Practitioner | 3121 Peach Orchard Rd, Augusta, GA 30906-3521 | 2010-10-14 |
| 1790830768 | Christopher James Davidson | Pharmacist | 3121 Peach Orchard Rd, Suite 101, Augusta, GA 30906-3521 | 2007-01-23 |
| 1447349998 | Bakco Enterprises,inc | Pharmacy | 3121 Peach Orchard Rd, Augusta, GA 30906-3521 | 2006-10-12 |
| 1528010790 | Uh Internal Medicine Partners | Internal Medicine | 3121 Peach Orchard Rd, Suite 201, Augusta, GA 30906-3521 | 2006-05-16 |
| 1508832338 | Renee Coughlin | Internal Medicine | 3121 Peach Orchard Rd, Suite 103, Augusta, GA 30906-3521 | 2006-02-23 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255969432 | Barton Chapel Dental Group, LLC | Dentist | 2755 Barton Chapel Road, Augusta, GA 30906 | 2020-04-01 |
| 1255897419 | Pediatric Mobility Innovations | Durable Medical Equipment & Medical Supplies | 3114 Augusta Tech Drive Suite 404, Augusta, GA 30906 | 2019-02-13 |
| 1023539731 | Kristy Lee Gibbs | Registered Nurse | 3421 Mike Padgett Hwy Bldg C, Augusta, GA 30906 | 2017-07-03 |
| 1194186031 | Clifton Nane Williams | Counselor | 3230 Hampton Circle, Augusta, GA 30906 | 2016-03-18 |
| 1376929661 | Catherine A. Ganzy | Social Worker | 3405 Mike Padgett Highway; Building 201, East Central Regional Hosptial, Augusta, GA 30906 | 2015-08-10 |
| 1962810358 | Fatemeh Azadeh Paziraei | Dentist | 1631 Gordon Highway, Augusta Smiles Youth Dentistry, Augusta, GA 30906 | 2014-07-29 |
| 1568809770 | Brandon Jennings | Occupational Therapy Assistant | 2388 Old Mcduffie Rd, Augusta, GA 30906 | 2013-05-29 |
| 1811266646 | Eddie P Johnson IIi, Dmd, PC | Preferred Provider Organization | 2755 Barton Chapel Rd, Augusta, GA 30906 | 2011-12-23 |
| 1366739021 | Kerensa A Cooks | Registered Nurse | 3421 Mike Padgett Highway, Serenity Behavioral Health Systems, Augusta, GA 30906 | 2011-07-01 |
| 1265737423 | Pidcock Chiropractic, Inc. | Chiropractor | 3028 Peach Orchard Rd., Augusta, GA 30906 | 2011-01-20 |
| Find all providers in zip 30906 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134745953 | Molly C Shields | Pediatrics | Dugas Building Bg 107 1120 15th Street, Augusta, GA 30912-0001 | 2020-06-17 |
| 1033734918 | Lauren Wooten Smith | Pediatrics | Chog Pediatric Residency Program 1120 15th Street, Augusta, GA 30912-0001 | 2020-06-16 |
| 1487211199 | Ashley Elizabeth Miller | Pediatrics | 1146 Harper Street, Augusta, GA 30912-0001 | 2019-05-29 |
| 1952968737 | Kayla M. Lasota | Pediatrics | 11230 115th St Ae3042, Augusta, GA 30912 | 2019-05-28 |
| 1558824797 | John-david Constantine Bruce | Pediatrics | Dugas Building (bg-1071) 1120 15th Street, Augusta, GA 30912-0001 | 2019-04-12 |
| 1306229182 | Alexander James Eason | Pediatrics | Georgia Regents Medical Ctr, 1120 15th Street, Augusta, GA 30912-0001 | 2015-06-30 |
| 1184945339 | Shannon Nicole Myers | Pediatrics | 3727 Executive Center Dr, Augusta, GA 30907-2398 | 2010-06-22 |
| 1801113386 | Gerard Rubin | Pediatrics | 6 E Chestnut St Ste 310, Augusta, ME 04330-5717 | 2010-04-23 |
| 1013246487 | William Weston IIi | Pediatrics | 93 Bristlecone Ct., Augusta, GA 30909-1861 | 2009-12-15 |
| 1225285372 | Mustafa Musa Nimir | Pediatrics | 1120 15th St Ae-3042, Medical College of Georgia, Augusta, GA 30912-5000 | 2008-08-20 |
| 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.