DR. SUSAN CHRISTINE FAGAN (NPI# 1316276033) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316276033 |
| Entity Type | Individual |
| Full Name | DR. SUSAN CHRISTINE FAGAN |
| Credential | PHARM.D. |
| Practice Address |
Hm 1220 1120 15th Street University of Georgia College of Pharmacy Augusta GA 30912 |
| Mailing Address |
107 Blackhaw Dr North Augusta SC 29860-9218 |
| Practice Telephone | 7067214915 |
| Practice Fax Number | 7067213994 |
| Mailing Telephone | 7067214915 |
| Mailing Fax Number | 7067213994 |
| Enumeration Date | 2009-12-08 |
| Last Update Date | 2009-12-08 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1835P0018X |
Pharmacist Specialization: Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
RPH020270 | GA | Pharmacy Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699110536 | Susan C. Fagan | Registered Nurse | 1040 Chevelle Dr, Baton Rouge, LA 70806-7805 | 2013-05-06 |
| 1851594899 | Susan Michelle Fagan | Social Worker | 185 Center Street Suite B, Wallingford, CT 06492 | 2007-06-07 |
| 1891858742 | Susan Millie Fagan | Dentist | 5281 Lapeer Road, Kimball, MI 48074 | 2006-12-19 |
| 1922078351 | Susan Fagan | Physical Therapist | 1 Emily Way, West Hartford, CT 06107-3136 | 2006-01-26 |
| 1972963684 | Susan Fagan | Behavioral Analyst | 6 Southside Rd, Danvers, MA 01923-1409 | 2016-02-24 |
| 1568781086 | Susan Fagan | Occupational Therapist | 22 Masonic Ave, Wallingford, CT 06492-3048 | 2010-05-24 |
| 1043468556 | Susan Marie Fagan | Counselor | 12125 Woodcrest Executive Dr, Suite 110, Saint Louis, MO 63141-5001 | 2008-09-09 |
| Street Address |
HM 1220 1120 15TH STREET UNIVERSITY OF GEORGIA COLLEGE OF PHARMACY |
| City | AUGUSTA |
| State | GA |
| Zip Code | 30912 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548885940 | Hannah Gullickson Folsom | Family Medicine | 1459 Laney Walker Blvd Ae 3042, Augusta, GA 30912 | 2020-06-11 |
| 1487278909 | Robert Kennedy | Internal Medicine | Augusta University Internal Medicine Residency Program, 1120 15th Street, Bi 5070, Augusta, GA 30912 | 2020-06-01 |
| 1952968737 | Kayla M. Lasota | Pediatrics | 11230 115th St Ae3042, Augusta, GA 30912 | 2019-05-28 |
| 1003379280 | Kayla Cox | Internal Medicine | 1120 15th St Bi5070, Augusta, GA 30912 | 2019-04-13 |
| 1619435740 | Justin Ray Mackert | Student in an Organized Health Care Education/Training Program | Augusta University, 1120 15th Street, Gc 5110, Augusta, GA 30912 | 2019-03-07 |
| 1417444167 | Victor Celis | Dentist | John Wesley Gilbert Dr, Augusta, GA 30912 | 2018-04-18 |
| 1487157921 | Julie Ann Matsen | Student in an Organized Health Care Education/Training Program | 997 St. Sebastian Way, Eg-2021-10, Augusta Univ., Dept. of Psychiatry & Health Behavior, Augusta, GA 30912 | 2018-03-12 |
| 1497287031 | Luke Yuung-jier Chang | Ophthalmology | 1120 15th St # Ba2720, Augusta, GA 30912 | 2017-04-02 |
| 1821537622 | Lashawn Kay Boone | Nurse Practitioner | 1445 Harper St, Augusta, GA 30912 | 2017-02-14 |
| 1134675564 | Arnab Saha | Internal Medicine | 1120 15 Th St., Augusta, GA 30912 | 2016-08-26 |
| Find all providers in zip 30912 | ||||
| Taxonomy Code | 1835P0018X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| Specialization | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
| Pharmacist Clinician/Clinical Pharmacy Specialist is a pharmacist with additional training and an expanded scope of practice that may include prescriptive authority, therapeutic management, and disease management. |
| Notes: Source: National Uniform Claim Committee, 2007 [1/1/2008: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609491281 | Melinda Kezer Drylie | Pharmacist | 1 Freedom Way, Augusta, GA 30904-6258 | 2020-06-10 |
| 1669009619 | Dalton Nuse | Pharmacist | 1510 Ohio St, Augusta, KS 67010-2189 | 2020-03-26 |
| 1740787472 | Katherine Donnan | Pharmacist | 1 Freedom Way, Augusta, GA 30904-6258 | 2018-04-09 |
| 1396244034 | Reid Wallace Griffin | Pharmacist | 1537 Walton Way, Augusta, GA 30904-3764 | 2018-02-08 |
| 1619499910 | Chantheara Long | Pharmacist | 1 Va Ctr, Augusta, ME 04330-6719 | 2017-07-09 |
| 1457726663 | Sudharsan Periyasamy Thandavan | Pharmacist | 2744 Washington Rd, Augusta, GA 30909-2218 | 2015-12-14 |
| 1902274921 | Anishka Walker | Pharmacist | 950 15th St, Charlie Norwood Vamc - Pharmacy Department, Augusta, GA 30901-2608 | 2015-09-08 |
| 1073992020 | Kathleen Cleary | Pharmacist | 1 Va Ctr, Augusta, ME 04330-6719 | 2015-05-22 |
| 1477946531 | Amber Ladak | Pharmacist | 1120 15th St, Augusta, GA 30912-0004 | 2015-03-13 |
| 1699165548 | Tim Robinson | Pharmacist | 1120 15th St, Bi-2101, Augusta, GA 30912-0004 | 2015-01-30 |
| 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.