BOUNTHAVY HOMSOMBATH (NPI# 1225281330) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1225281330 |
| Entity Type | Individual |
| Full Name | BOUNTHAVY HOMSOMBATH |
| Credential | MD |
| Practice Address |
3675 J Dewey Gray Cir Suite 300 Augusta GA 30909-1868 |
| Mailing Address |
Po Box 3726 Augusta GA 30914-3726 |
| Practice Telephone | 7068639595 |
| Practice Fax Number | 8887453917 |
| Mailing Telephone | 7068639595 |
| Mailing Fax Number | 8887453917 |
| Enumeration Date | 2008-11-03 |
| Last Update Date | 2020-05-05 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208600000X | Surgery | 68031 | GA | Allopathic & Osteopathic Physicians |
| N | 2086S0102X |
Surgery Specialization: Surgical Critical Care |
068031 | GA | Allopathic & Osteopathic Physicians |
| Street Address |
3675 J DEWEY GRAY CIR SUITE 300 |
| City | AUGUSTA |
| State | GA |
| Zip Code | 30909-1868 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750351326 | Richard J Cartie | Pediatrics | 3675 J Dewey Gray Cir, Suite 300, Augusta, GA 30909-1868 | 2006-01-25 |
| 1881046092 | Nichole Miller | Nurse Practitioner | 3675 J Dewey Gray Cir, Suite 300, Augusta, GA 30909-1868 | 2016-07-12 |
| 1700255452 | Ansley Thompson Coffey | Physician Assistant | 3675 J Dewey Gray Cir, Suite 300, Augusta, GA 30909-1868 | 2015-09-23 |
| 1275901431 | Erin Cota | Physician Assistant | 3675 J Dewey Gray Cir, Suite 300, Augusta, GA 30909-1868 | 2015-09-04 |
| 1578954533 | Jennifer Casella | Nurse Practitioner | 3675 J Dewey Gray Cir, Ste. 300, Augusta, GA 30909-1868 | 2015-02-12 |
| 1467852376 | Crystal Whitaker Helmly | Nurse Practitioner | 3675 J Dewey Gray Cir, Suite 300, Augusta, GA 30909-1868 | 2014-08-27 |
| 1770917833 | Melania Velasquez | Physician Assistant | 3675 J Dewey Gray Cir, Ste. 300, Augusta, GA 30909-1868 | 2013-08-26 |
| 1245664309 | Jesse Paul Shuff | Physician Assistant | 3675 J Dewey Gray Cir, Ste. 300, Augusta, GA 30909-1868 | 2013-08-26 |
| 1417396904 | Angela E Dykes | Nurse Practitioner | 3675 J Dewey Gray Cir, Ste. 300, Augusta, GA 30909-1868 | 2013-06-18 |
| 1740565027 | Lisa Owens Campbell | Nurse Practitioner | 3675 J Dewey Gray Cir, Ste. 300, Augusta, GA 30909-1868 | 2011-10-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912513888 | Lauran Simpson | Behavior Technician | 1237 Augusta West Parkway, Augusta, GA 30909 | 2020-09-16 |
| 1487273884 | Still Perspectives Counseling LLC | Counselor | 1265 Inerstate Prwy, Suite B, Augusta, GA 30909 | 2020-04-15 |
| 1598397838 | Mjra Medical LLC | Psychologist | 3675 J Dewey Gray Cr Ste 300, Augusta, GA 30909 | 2020-02-05 |
| 1003452319 | Danny Robinson | Counselor | 2609 Commons Boulevard, Augusta, GA 30909 | 2019-11-21 |
| 1407498637 | Candice M Cruse | Social Worker | 2609 Commons Blvd, Augusta, GA 30909 | 2019-10-09 |
| 1902363385 | Mary D Jodon | Pharmacist | 3338 Wrightsboro Rd., Augusta, GA 30909 | 2019-02-21 |
| 1447790514 | Burn Critical Care Associates, LLC | Internal Medicine | 3614 J. Dewey Gray Circle, Bldg B., Augusta, GA 30909 | 2017-03-08 |
| 1124561766 | Sasha Latara Mccraw | Counselor | 7303 Palomino Court, Augusta, GA 30909 | 2016-11-30 |
| 1174974620 | Warren Umansky, Ph.d. | Psychologist | 302 Wheeler Executive Ctr, Augusta, GA 30909 | 2016-06-27 |
| 1811358955 | Theodora Mcleskey | Nurse Practitioner | 1215 George C. Wilson Drive, Augusta, GA 30909 | 2016-03-17 |
| Find all providers in zip 30909 | ||||
| Taxonomy Code | 208600000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery. |
| 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 Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568087260 | Anthony George Campbell | Surgery | 1475 Laney Walker Blvd, Augusta, GA 30912-0002 | 2020-06-09 |
| 1821613431 | America Stephanie Revere | Surgery | Augusta University Medical Center 1120 15th St, Augusta, GA 30912-0001 | 2020-06-09 |
| 1033779152 | Kathryne Holmes | Surgery | 1120 15th St Rm Bi4076, Augusta, GA 30912-0004 | 2019-06-20 |
| 1851958896 | Joseph Benjamin Pitt | Surgery | 1120 15th St # Bi-4072, Augusta, GA 30912-0004 | 2019-05-24 |
| 1508387499 | Lydia Kaoutzani | Surgery | 1120 15th St. Bi, Augusta, GA 30912-5501 | 2017-06-29 |
| 1699058362 | Harry C. Sherman | Surgery | 5 Rockbrook Rd, Augusta, GA 30909-3760 | 2011-09-20 |
| 1578745089 | General & Vascular Surgery Associates of Augusta, PC | Surgery | 1207 W Medical Park Rd, Augusta, GA 30909-4504 | 2007-11-27 |
| 1316128432 | Francisco Javier Jacome | Surgery | 2101 Central Ave, Augusta, GA 30904-6706 | 2007-11-16 |
| 1285857391 | Adil M Abuzeid | Surgery | 1120 15th St # Ba-4411, Georgia Regents Medical Associates, Augusta, GA 30912-0004 | 2007-04-10 |
| 1174687123 | Barry J Jenkins | Surgery | 1348 Walton Way Ste 6500, Augusta, GA 30901-5111 | 2006-12-21 |
| 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.