GOLDEN ISLES MEDICAL LLC (NPI# 1215254065) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215254065 |
| Entity Type | Organization |
| Organization Name | GOLDEN ISLES MEDICAL LLC |
| Practice Address |
1015 Arthur J Moore Dr Saint Simons Island GA 31522-2206 |
| Mailing Address |
Po Box 30062 Sea Island GA 31561-0062 |
| Practice Telephone | 9122677780 |
| Mailing Telephone | 9122677780 |
| Enumeration Date | 2010-05-03 |
| Last Update Date | 2013-01-08 |
| Authorized Official Name | DR. ANNA CABECA (CMO) |
| Authorized Official Telephone | 9122677780 |
| Authorized Official Credential | DO |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | Other Service Providers |
| Street Address |
1015 ARTHUR J MOORE DR |
| City | SAINT SIMONS ISLAND |
| State | GA |
| Zip Code | 31522-2206 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215950431 | Diane Gwyn Bowen | Surgery | 1015 Arthur J Moore Dr, Saint Simons Island, GA 31522-2206 | 2006-07-26 |
| 1922387349 | Laura Hepner | Massage Therapist | 1015 Arthur J Moore Dr, Saint Simons Island, GA 31522-2206 | 2011-08-16 |
| 1386736064 | Robert W Bowen | Obstetrics & Gynecology | 1015 Arthur J Moore Dr, Saint Simons Island, GA 31522-2206 | 2006-09-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982186342 | Matthew Mackinnon Gibbs | Specialist/Technologist | 211 Village Dr, St Simons Is, GA 31522 | 2018-09-02 |
| 1770957433 | Jennifer Herrin, Lpc | Community/Behavioral Health | 400 Main Street, Cottage 1, Saint Simons Island, GA 31522 | 2015-11-18 |
| 1508113002 | Ashley Neal Callicutt | Counselor | 301 Sea Island Road, Suite G, St. Simons Island, GA 31522 | 2012-08-14 |
| 1235414103 | Dana D'andrea Duggan | Psychologist | 283 Redfern Village, St. Simons Island, GA 31522 | 2011-10-11 |
| 1528394848 | Nancy Hodges Bowen | Nurse Practitioner | 7000 Wellness Way, Suite 130, St. Simons Island, GA 31522 | 2009-10-21 |
| 1073763215 | John Arthur Hendry | Dentist | 511 Mallery Street, St. Simons Island, GA 31522 | 2008-09-24 |
| 1770775116 | Randolph M. Stevens | Dentist | Coastal Endodontic Associates, 1804 Frederica Rd., Ste B, St. Simons Island, GA 31522 | 2007-08-09 |
| 1689797383 | Angela C Barnard | Nurse Practitioner | 798 Mallery St Apt 2, Saint Simons Island, GA 31522 | 2007-04-09 |
| 1053493486 | Larry D. Daugherty | Dentist | 124 Island Professional Park, St Simons Island, GA 31522 | 2006-10-19 |
| 1134239460 | Joe Neil Garner | Dentist | 288 Redfern Village, St Simons Island, GA 31522 | 2006-08-30 |
| Find all providers in zip 31522 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336307404 | John Franklin Sisley IIi | Specialist | 119 Alder Cir, Saint Simons Island, GA 31522-1102 | 2008-05-27 |
| 1639150790 | William J. Davanzo, M.d., P.C. | Specialist | 143 Follins Ln, Saint Simons Island, GA 31522-4263 | 2005-11-07 |
| 1558366534 | Ashley C Cavalier | Specialist | 2485 Demere Rd, Suite C100, Saint Simons Island, GA 31522-5634 | 2005-06-16 |
| 1164403234 | Barbara Davanzo, M.d., P.C. | Specialist | 143 Follins Ln, Saint Simons Island, GA 31522-4263 | 2005-11-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073113718 | Jennifer Lynn Harper | Specialist | 46 Rice Lewis Gilliard Dr, Toccoa, GA 30577-3683 | 2020-10-30 |
| 1265030407 | Sandra W Paul | Specialist | 4185 Glad Morning Dr, Atlanta, GA 30349-3902 | 2020-10-10 |
| 1851907992 | Diana Rowe | Specialist | 35 Homeplace Dr, Covington, GA 30016-8539 | 2020-09-23 |
| 1053926154 | Idoc Virtual Neuro Critical Care LLC | Specialist | 159 E Wesley Rd Ne, Atlanta, GA 30305-3707 | 2020-09-15 |
| 1649885179 | Rakiya Parker | Specialist | 4814 Stone Mountain Hwy Ste 9, Lilburn, GA 30047-4649 | 2020-09-11 |
| 1649888785 | Valeria Kim West | Specialist | 204 W Oglethorpe Hwy, Hinesville, GA 31313-3615 | 2020-07-15 |
| 1225658511 | Louis P Towles IIi | Specialist | 755 Commerce Dr Ste 600, Decatur, GA 30030-2619 | 2020-04-16 |
| 1316566755 | Kindle-simone Friedlander | Specialist | 13988 Sunfish Bnd, Alpharetta, GA 30004-0605 | 2020-04-15 |
| 1184252595 | Peachtree Surgical Assistants Inc | Specialist | 59 Anderson Ave Apt 127, Canton, GA 30114-2330 | 2020-03-31 |
| 1164056859 | Bimal R Shah Md PC | Specialist | 820 Saint Sebastian Way Ste 2a, Augusta, GA 30901-2636 | 2020-03-03 |
| Find all providers with the same taxonomy | ||||
| City | SAINT SIMONS ISLAND |
| Zip Code | 31522 |
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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.