JAMES ROBERT COSTELLO (NPI# 1215115233) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215115233 |
| Entity Type | Individual |
| Full Name | JAMES ROBERT COSTELLO |
| Credential | MD |
| Practice Address |
770 Pine St Suite 290 Macon GA 31201-2173 |
| Practice Telephone | 4787431458 |
| Practice Fax Number | 4787551332 |
| Mailing Telephone | 4787431458 |
| Mailing Fax Number | 4787551332 |
| Enumeration Date | 2008-01-31 |
| Last Update Date | 2017-05-09 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
001415 | GA | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881021723 | James Costello | Durable Medical Equipment & Medical Supplies | 110 Adams St, Saratoga Springs, NY 12866-5002 | 2013-10-10 |
| 1457600041 | James Paul Costello | Dentist | 862 Shellbark Way, The Villages, FL 32162-4075 | 2012-08-29 |
| 1811190515 | James Costello | Chiropractor | 4615 I- 45 North Freeway Ste#208, Houston, TX 77022 | 2007-06-08 |
| 1144733981 | James Jay Costello | Counselor | 1 Kellogg Cir, Emporia, KS 66801-5415 | 2017-11-15 |
| 1033649959 | James Costello | Student in an Organized Health Care Education/Training Program | 18 E Laurel Road, Stratford, NJ 08084 | 2017-06-13 |
| 1851711717 | James Michael Costello | Registered Nurse | 830 Chalkstone Ave, Providence, RI 02908-4734 | 2014-04-18 |
| 1740386887 | James Patrick Costello | Optometrist | 3217 Lake Ave, Wilmette, IL 60091-1080 | 2006-09-16 |
| 1760498901 | James W. Costello | Anesthesiology | 3626 Ruffin Rd, San Diego, CA 92123-1810 | 2006-07-31 |
| 1801883236 | James Costello | Pediatrics | 4120 Prescott Rd, Modesto, CA 95356-8418 | 2005-09-30 |
| Street Address |
770 PINE ST SUITE 290 |
| City | MACON |
| State | GA |
| Zip Code | 31201-2173 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720080443 | Stephen Ashley Noller | Internal Medicine | 770 Pine St, Suite 480, Macon, GA 31201-2173 | 2005-08-12 |
| 1821440819 | Southern Lung Specialists PC | Internal Medicine | 770 Pine St, Suite 560, Macon, GA 31201-7569 | 2016-07-01 |
| 1780009092 | Kimberley G Craddock | Occupational Therapist | 770 Pine St, Macon, GA 31201-2173 | 2014-02-24 |
| 1366796930 | Village Podiatry Group, LLC | Podiatrist | 770 Pine St, Ste 300, Macon, GA 31201-2173 | 2012-11-05 |
| 1275888661 | Hannah R Beauchamp | Nurse Practitioner | 770 Pine St, Ste 520, Macon, GA 31201-2173 | 2012-07-21 |
| 1427324615 | Sushmita Nair | Pediatrics | 770 Pine St, Ste 520, Macon, GA 31201-2173 | 2012-04-01 |
| 1235423047 | Burton D Goodwin Jr. | Radiology | 770 Pine St, Suite 290, Macon, GA 31201-2173 | 2011-06-09 |
| 1831495696 | Annie Lee Williams | Radiology | 770 Pine St, Suite 290, Macon, GA 31201-2173 | 2011-01-26 |
| 1629371638 | Cardiovascular Associates of Macon, PC | Specialist | 770 Pine St, Suite 480, Macon, GA 31201-2173 | 2010-12-13 |
| 1932429024 | Dr Brown N Ekeledo LLC | Surgery | 770 Pine St, Suite 550, Macon, GA 31201-2173 | 2010-06-11 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639666340 | Yasameen Emad Muzahim | Internal Medicine | 777 Hemlock Street, Msc 165, Macon, GA 31201 | 2018-04-18 |
| 1952819419 | Putnam Dialysis LLC | Clinic/Center | 657 Hemlock Street, Suite 200, Macon, GA 31201 | 2018-01-18 |
| 1730604331 | Graham Arthur Mercier | Surgery | 169 Ashley Ave., Room 202 Main Hospital Msc 333, Charleston, SC 31201 | 2017-08-04 |
| 1376075705 | Diamond Jude | Internal Medicine | 777 Hemlock Street Msc #104, Macon, GA 31201 | 2017-04-03 |
| 1174055263 | Carol Roobin Bashuk | Hearing Instrument Specialist | 634 First Street, Macon, GA 31201 | 2017-03-29 |
| 1144752411 | Hubert Pare | Student in an Organized Health Care Education/Training Program | 777 Hemlock Street, Msc# 165, Macon, GA 31201 | 2017-03-28 |
| 1548613789 | Michael Daugherty | Counselor | 1873 Hardeman Ave, Suite 1, Macon, GA 31201 | 2016-07-22 |
| 1316317993 | 4front Healthcare of Middle Georgia, LLC | Hospice Care, Community Based | 682 1st St, Macon, GA 31201 | 2015-09-25 |
| 1881073054 | Andrew Lee Drahos | Surgery | 777 Hemlock St # 140, Macon, GA 31201 | 2015-05-21 |
| 1720474158 | April Nicole Colley | Nurse Practitioner | 1014 Forsyth Street, Macon, GA 31201 | 2015-04-13 |
| Find all providers in zip 31201 | ||||
| Taxonomy Code | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| 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 Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134101199 | Mark Edward Barrow | Radiology | 770 Pine Street, Suite 290, Macon, GA 31201-7516 | 2005-11-16 |
| 1114908522 | Central Georgia Mri LLC | Radiology | 770 Pine St Ste L15, Attn: Radiology Department, Macon, GA 31201-7519 | 2005-11-11 |
| 1609857317 | Northwest Diagnostic Imaging, Inc | Radiology | 2140 Riverside Dr, Macon, GA 31204-1747 | 2005-11-09 |
| 1437149762 | Central Georgia Pet LLC | Radiology | 1650 Hardeman Ave, Attn: Radiology Department, Macon, GA 31201-1418 | 2005-10-27 |
| 1326043688 | Arthur Hamilton Mccain | Radiology | 770 Pine St Ste 290, Attn: Radiology Department, Macon, GA 31201-7516 | 2005-06-14 |
| 1235423047 | Burton D Goodwin Jr. | Radiology | 770 Pine St, Suite 290, Macon, GA 31201-2173 | 2011-06-09 |
| 1831495696 | Annie Lee Williams | Radiology | 770 Pine St, Suite 290, Macon, GA 31201-2173 | 2011-01-26 |
| 1982922365 | Joshua Benjamin Cooper | Radiology | 770 Pine St, Suite 290, Macon, GA 31201-2173 | 2010-05-11 |
| 1609009760 | Open Mri of Georgia, Inc | Radiology | 2140 Riverside Dr, Macon, GA 31204-1747 | 2009-08-24 |
| 1194984583 | Alan D Kirsh | Radiology | 770 Pine St, Suite 290, Macon, GA 31201-2173 | 2008-06-02 |
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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.