MICAH HENDERSON LANCASTER (NPI# 1285917401) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1285917401 |
| Entity Type | Individual |
| Full Name | MICAH HENDERSON LANCASTER |
| Credential | PA-C |
| Practice Address |
1111 Glynco Pkwy Building 1, Suite 20 Brunswick GA 31525-7921 |
| Mailing Address |
2400 Bellevue Rd Suite 21-a Dublin GA 31021-2885 |
| Practice Telephone | 9122621801 |
| Practice Fax Number | 9122646262 |
| Mailing Telephone | 4782757202 |
| Mailing Fax Number | 4782748418 |
| Enumeration Date | 2011-09-23 |
| Last Update Date | 2015-03-12 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 006295 | GA | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363AM0700X |
Physician Assistant Specialization: Medical |
Physician Assistants & Advanced Practice Nursing Providers | ||
| N | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 003116432 | 05 | |
| GA | GEORGIA LICENSE | 006295 | 01 |
| GA | 003116443 | 05 |
| Street Address |
1111 GLYNCO PKWY BUILDING 1, SUITE 20 |
| City | BRUNSWICK |
| State | GA |
| Zip Code | 31525-7921 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922089713 | Northwest Diagnostic Imaging, Inc | Radiology | 1111 Glynco Pkwy, Brunswick, GA 31525-7921 | 2005-11-08 |
| 1639562978 | Tattnall Hospital Company, LLC | Orthopaedic Surgery | 1111 Glynco Pkwy, Suite 30 - A Summit Professional Plaza I, Brunswick, GA 31525-7921 | 2015-03-11 |
| 1487047726 | Optim Orthopedics, LLC | Orthopaedic Surgery | 1111 Glynco Pkwy, Suite 30 - A Summit Professional Plaza I, Brunswick, GA 31525-7921 | 2015-03-11 |
| 1376960179 | Joseph Durant | Specialist | 1111 Glynco Pkwy, Ste. 400, Brunswick, GA 31525-7921 | 2014-03-19 |
| 1760815880 | Kendra Curry | Social Worker | 1111 Glynco Pkwy, Bldg 2, Suite 200, Brunswick, GA 31525-7921 | 2013-08-12 |
| 1144575168 | Karah Lynn Brown | Physician Assistant | 1111 Glynco Pkwy, #2-100, Brunswick, GA 31525-7921 | 2012-07-16 |
| 1659643955 | Costrini & Meadows PC | Internal Medicine | 1111 Glynco Pkwy, Suite 410, Brunswick, GA 31525-7921 | 2012-02-01 |
| 1114215498 | Florida Bracing Centers, Inc. | Prosthetic/Orthotic Supplier | 1111 Glynco Pkwy, Building 2, Suite 110, Brunswick, GA 31525-7921 | 2011-07-20 |
| 1801105275 | Dublin Vamc | Clinic/Center | 1111 Glynco Pkwy, Summit Professional Plaza, Suite 200, Brunswick, GA 31525-7921 | 2010-10-01 |
| 1538495999 | Neurological Institute of Atlanta | Psychiatry & Neurology | 1111 Glynco Pkwy, Ste 400, Brunswick, GA 31525-7921 | 2009-10-20 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063905990 | Jonathon Wesley Capps | Physician Assistant | 1111 Glynco Pkwy Bldg 1, Ste 10, Brunswick, GA 31525 | 2018-06-14 |
| 1366993628 | Hands Down Muscle Restoration, Inc | Homeopath | 1212 Chapel Crossing Road, Brunswick, GA 31525 | 2016-10-20 |
| 1619424173 | Jebediah S Christy Dds - Brunswick Pllc | Dentist | 11455 Canal Crossing, Brunswick, GA 31525 | 2016-09-01 |
| 1831545508 | Heller Family Medicine, LLC | General Practice | 208 Scranton Connector Ste 120, Brunswick, GA 31525 | 2016-05-11 |
| 1437525391 | Natisha Danielle Hill | Occupational Therapy Assistant | 138 Wingefield Commons Drive, Brunswick, GA 31525 | 2015-08-14 |
| 1811269632 | Solar Family Practice | Family Medicine | 122 Scranton Connector, Suite 112, Brunswick, GA 31525 | 2012-02-09 |
| 1700187895 | Chetan Patel | Pharmacist | 12 Woodfall Ct, Brunswick, GA 31525 | 2010-11-05 |
| 1194914275 | Dialysis of Golden Isles, LLC | Clinic/Center | 475 Gateway Center Blvd, Brunswick, GA 31525 | 2007-10-15 |
| 1902939325 | Gateway Behavioral Health Services | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 111 Frazier Street, Brunswick, GA 31525 | 2007-03-14 |
| 1609909498 | Gateway Behavioral Health Services | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 115 Frazier Road, Brunswick, GA 31525 | 2007-03-13 |
| Find all providers in zip 31525 | ||||
| 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 |
|---|---|---|---|---|
| 1063905990 | Jonathon Wesley Capps | Physician Assistant | 1111 Glynco Pkwy Bldg 1, Ste 10, Brunswick, GA 31525 | 2018-06-14 |
| 1518225358 | Timothy Paul Katoski | Physician Assistant | 135 Wood Crest Cir, Brunswick, GA 31525-6887 | 2012-04-30 |
| 1992076111 | Benjamin C. Tyau | Physician Assistant | 193 Bath Rd, Brunswick, ME 04011 | 2012-01-19 |
| 1376617167 | Maureen Kilrain | Physician Assistant | 3059 Grafton Rd, Brunswick, OH 44212 | 2006-11-20 |
| 1811077696 | Karen Anne Marlin | Physician Assistant | Dudley Coe Health Center Bowdoin College, 3600 College Station, Brunswick, ME 04011 | 2006-10-16 |
| 1093782856 | Ismael S Osta | Physician Assistant | 3226 Hampton Ave, Suite G, Brunswick, GA 31520-4225 | 2006-03-01 |
| 1275504771 | Alta Anesthesia Associates of Georgia, PC | Physician Assistant | 3100 Kemble Ave, Brunswick, GA 31520-4211 | 2006-02-01 |
| 1770124026 | Calysta Lane Medley | Physician Assistant | 600 Coastal Village Dr, Brunswick, GA 31520-1973 | 2019-10-07 |
| 1619525995 | Rachel Putnam | Physician Assistant | 14 Maine St # 44, Brunswick, ME 04011-2049 | 2019-08-29 |
| 1043871494 | Erin Ferguson | Physician Assistant | 3025 Shrine Rd Ste 390, Brunswick, GA 31520-4786 | 2019-06-26 |
| Find all providers in BRUNSWICK | ||||
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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.