MISS ALYSSA BROADWATER


Address: 5665 Peachtree Dunwoody Rd, Atlanta, GA 30342-1764
Phone: 4047787200

MISS ALYSSA BROADWATER (NPI# 1245866276) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1245866276
Entity Type Individual
Full Name MISS ALYSSA BROADWATER
Credential PA-C
Practice Address 5665 Peachtree Dunwoody Rd
Atlanta
GA 30342-1764
Mailing Address 731 Paint Horse Dr
Canton
GA 30115-6817
Practice Telephone 4047787200
Mailing Telephone 3864058814
Enumeration Date 2020-03-21
Last Update Date 2020-07-20
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363AS0400X Physician Assistant
Specialization: Surgical Technologist
Physician Assistants & Advanced Practice Nursing Providers

Other Providers ALYSSA BROADWATER

NPI Name Taxonomy Address Enumeration
1063966984 Alyssa Reau Broadwater Dietitian, Registered 4353 Tuller Rd Ste K, Dublin, OH 43017-5071 2016-08-09

Office Location

Street Address 5665 PEACHTREE DUNWOODY RD
City ATLANTA
State GA
Zip Code 30342-1764

Providers in the same location

NPI Name Taxonomy Address Enumeration
1235739376 Joel John Varghese Registered Nurse 5665 Peachtree Dunwoody Rd, Atlanta, GA 30342-1764 2020-10-28
1942810130 Alexander Douglas Yox Anesthesiologist Assistant 5665 Peachtree Dunwoody Rd, Atlanta, GA 30342-1764 2020-08-03
1265056352 Julie Thi Quach Nurse Practitioner 5665 Peachtree Dunwoody Rd, Atlanta, GA 30342-1764 2020-06-03
1104462571 Amanda Dostie Registered Nurse 5665 Peachtree Dunwoody Rd, Atlanta, GA 30342-1764 2019-11-20
1164067112 Eltayeb Mohamed Ahmed Thoracic Surgery (Cardiothoracic Vascular Surgery) 5665 Peachtree Dunwoody Rd, Atlanta, GA 30342-1764 2019-11-14
1104468826 Leanna Nicole Hutto Registered Nurse 5665 Peachtree Dunwoody Rd, Atlanta, GA 30342-1764 2019-10-14
1083255376 Katelyn Lott Nurse Practitioner 5665 Peachtree Dunwoody Rd, Atlanta, GA 30342-1764 2019-10-08
1033750278 Marjorie Marilyn White Nurse Practitioner 5665 Peachtree Dunwoody Rd, Atlanta, GA 30342-1764 2019-09-29
1144872789 Jeannie Stamps Aldridge Anesthesiologist Assistant 5665 Peachtree Dunwoody Rd, Atlanta, GA 30342-1764 2019-07-14
1881159192 Sylvia Diana Sajna Registered Nurse 5665 Peachtree Dunwoody Rd, Atlanta, GA 30342-1764 2019-01-31
Find all providers in the same location

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1144820614 Nia Charnice Griffin Nurse Practitioner 5670 Peachtree Dunwoodyroad, Suite 900, Atlanta, GA 30342 2020-10-26
1255945184 Jennifer Lynne Cole Behavior Technician 5555 Glenridge Con Suite 200, Atlanta, GA 30342 2020-09-08
1093336232 Van Tran Respiratory Therapist, Registered 1000 Johnson Ferry Rd Ne, Atlanta, Ga 30342, Atlanta, GA 30342 2020-04-28
1356978340 Twyla Douglas Jackson I Clinical Nutrition, 1000 Johnson Ferry Rd Ne, Atlanta, GA 30342 2020-03-27
1760013411 Emily Hamm Dietitian, Registered 933 D Johnson Ferry Road, Suite 250, Atlanta, GA 30342 2020-01-31
1043855984 Mackenzie Tucker Wayda Registered Nurse 1001 Johnson Ferry Rd. Ne, Atlanta, GA 30342 2019-11-14
1386288454 Tiauna Lashun Cochman Psychologist 1307 Glenridge Dr, Sandy Springs, GA 30342 2019-11-01
1164074399 Stephen J. White Hearing Instrument Specialist 5775 Peachtree Dunwoody Rd Suite 600 Fl. 6, Uhc Hearing, Atl., GA 30342 2019-07-09
1144788142 Jaytyn LLC Internal Medicine 4600 Broswell Road, Atlanta, GA 30342 2019-03-08
1760954705 Mishele Walker LLC Counselor 555 Glenridge Connector, Suite 200, Sandy Springs, GA 30342 2018-12-31
Find all providers in zip 30342

Taxonomy Information

Taxonomy Code 363AS0400X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Physician Assistant
Specialization Surgical Technologist

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1912356775 Jason Weddington Physician Assistant 5667 Peachtree Dunwoody Rd Ste 220, Atlanta, GA 30342-1725 2016-06-11
1578937181 Vds Surgical Assistants, Inc. Physician Assistant 1307 W Garmon Rd, Atlanta, GA 30327-4405 2015-11-19
1407220379 Simpson Surgery Group, LLC Physician Assistant 701 Highland Ave Ne Apt 1407, #1407, Atlanta, GA 30312-1454 2015-11-16
1417388232 Tracey Lorena Tello Physician Assistant 931 Monroe Drive Ne, Suite 102 #641, Atlanta, GA 30308-7132 2013-12-04
1336587401 Marissa B Highnote Physician Assistant 6045 Barfield Rd Ste 100, Atlanta, GA 30328-4402 2013-06-11
1396013223 Signature Surgical Assistants Physician Assistant 2489 Kings Arms Dr Ne, Atlanta, GA 30345-2132 2011-12-07
1720364318 Leah Strickland Physician Assistant 4279 Roswell Road Suite 102 Pmb 303, Atlanta, GA 30342 2011-10-26
1669798872 Tiffiany Mccune Physician Assistant 4979 Lower Elm St, Atlanta, GA 30349-1677 2010-04-13
1306177233 Hong Feng Shi Physician Assistant 4355 Cobb Pkwy Ste J131, Atlanta, GA 30339-3887 2010-01-15
1821256223 Clyde D Johnson Jr. Physician Assistant 5881 Glendrige Dr Ne, Suite 120, Atlanta, GA 30328 2008-06-02
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Competitor

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City ATLANTA
Zip Code 30342

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Dataset Information

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.

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