RAYLLENSONS ITACY (NPI# 1174804702) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174804702 |
| Entity Type | Individual |
| Full Name | RAYLLENSONS ITACY |
| Credential | P.A. |
| Practice Address |
2020 Cumming Highway Suite 102 Canton GA 30115 |
| Mailing Address |
550 Peachtree St Ne Suite 1600 Atlanta GA 30308-2212 |
| Practice Telephone | 6785931295 |
| Practice Fax Number | 6785931294 |
| Mailing Telephone | 4048811094 |
| Mailing Fax Number | 4048741249 |
| Enumeration Date | 2011-09-09 |
| Last Update Date | 2016-04-05 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 006147 | GA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
2020 CUMMING HIGHWAY SUITE 102 |
| City | CANTON |
| State | GA |
| Zip Code | 30115 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497364806 | Amanda Arbogast | Speech-Language Pathologist | 610 Royal Crest Court, Canton, GA 30115 | 2020-07-31 |
| 1033754163 | Kelly Marie Shirley | Nurse Practitioner | 450 Northside Cherokee Blvd., Radiology Dept., Canton, GA 30115 | 2019-11-13 |
| 1700394319 | Jennifer Lynn Davenport | Nurse Practitioner | 684 Sixes Rd Ste 125, Holly Springs, GA 30115 | 2018-01-17 |
| 1851717961 | Wal-mart Stores East, Lp | Technician/Technologist | 2200 Holly Springs Pkey, Holly Springs, GA 30115 | 2014-03-13 |
| 1194148502 | Julia Bedingfield Reid | Pharmacist | 450 Northside Cherokee Blvd Ste T20, Canton, GA 30115 | 2014-01-22 |
| 1447597992 | America's Best Contacts & Eyeglasses | Technician/Technologist | 2030 Cumming Highway, Suite 106, Canton, GA 30115 | 2013-01-03 |
| 1679821193 | Jill M Decorso | Speech-Language Pathologist | 4280 Hickory Flat Hwy, Ste 108, Canton, GA 30115 | 2012-08-15 |
| 1306113378 | Sidney Boyd Collier IIi | Pharmacist | 6111 Hickory Flat Highway, Canton, GA 30115 | 2011-11-18 |
| 1245534346 | Kim M. Mcmillan | Counselor | 154 Lakeside Drive, Canton, GA 30115 | 2011-01-04 |
| 1144457177 | Amy Jennifer Jones | Occupational Therapist | #1 Mcgarity Rd., Canton, GA 30115 | 2009-06-17 |
| Find all providers in zip 30115 | ||||
| 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 |
|---|---|---|---|---|
| 1164048674 | Rebecca Lynn Yunk | Physician Assistant | 50433 Monroe St, Canton, MI 48188-6601 | 2020-06-20 |
| 1780210781 | Olivia Anastasia Basso | Physician Assistant | 4912 Higbee Ave Nw Ste 200, Canton, OH 44718-2599 | 2020-03-21 |
| 1700428802 | Meagan Elizabeth Hogan | Physician Assistant | 6119 Us Highway Route 11, Canton, NY 13617 | 2019-10-10 |
| 1578113593 | Luiza Lica | Physician Assistant | 246 Princess Dr, Canton, MI 48188-1142 | 2019-09-12 |
| 1235614900 | Eva Louisa Paoloni | Physician Assistant | 1105 W Maple St Apt 3, Canton, OH 44720-2869 | 2018-09-28 |
| 1992281653 | Elizabeth Judy | Physician Assistant | 460 Northside Cherokee Blvd Ste 430, Canton, GA 30115-8020 | 2018-07-16 |
| 1083124051 | Stephanie Black | Physician Assistant | 1455 Harrison Ave Nw Ste 105, Canton, OH 44708-2609 | 2017-10-04 |
| 1972024594 | Patrick James Sullivan | Physician Assistant | 6619 State Highway Route 11, Canton, NY 13617 | 2017-07-05 |
| 1588111074 | Kinjal Shah | Physician Assistant | 43767 Ford Rd, Canton, MI 48187-3185 | 2016-09-01 |
| 1144683731 | Ellen Catherine Mitchell | Physician Assistant | 48575 Joy Rd, Canton, MI 48187-1214 | 2016-03-31 |
| Find all providers in CANTON | ||||
Please comment or provide details below to improve the information on RAYLLENSONS ITACY.
| 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.