UNIVERSITY MEDICAL GROUP LLC (NPI# 1336413954) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336413954 |
| Entity Type | Organization |
| Organization Name | UNIVERSITY MEDICAL GROUP LLC |
| Practice Address |
3121 Peach Orchard Rd Ste 103 Augusta GA 30906-3531 |
| Mailing Address |
Po Box 1705 Augusta GA 30903-1705 |
| Practice Telephone | 7067925075 |
| Practice Fax Number | 7067925085 |
| Mailing Telephone | 7067747263 |
| Mailing Fax Number | 7067747230 |
| Enumeration Date | 2012-02-29 |
| Last Update Date | 2018-05-07 |
| Authorized Official Name | JULIE DEASON (DIRECTOR, PHYSICIAN REVENUE CYCLE) |
| Authorized Official Telephone | 7067748326 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians | ||
| N | 208D00000X | General Practice | Allopathic & Osteopathic Physicians | ||
| Y | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871885806 | University Medical Group LLC | Family Medicine | 3486 Peach Orchard Rd Ste 100, Augusta, GA 30906-5215 | 2011-05-10 |
| 1104199751 | University Medical Group LLC | Internal Medicine | 309 West Ave, North Augusta, SC 29841-3800 | 2012-02-13 |
| Street Address |
3121 PEACH ORCHARD RD STE 103 |
| City | AUGUSTA |
| State | GA |
| Zip Code | 30906-3531 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720634397 | Meredith Carr | Nurse Practitioner | 3121 Peach Orchard Rd Ste 103, Augusta, GA 30906-3531 | 2019-08-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255969432 | Barton Chapel Dental Group, LLC | Dentist | 2755 Barton Chapel Road, Augusta, GA 30906 | 2020-04-01 |
| 1255897419 | Pediatric Mobility Innovations | Durable Medical Equipment & Medical Supplies | 3114 Augusta Tech Drive Suite 404, Augusta, GA 30906 | 2019-02-13 |
| 1023539731 | Kristy Lee Gibbs | Registered Nurse | 3421 Mike Padgett Hwy Bldg C, Augusta, GA 30906 | 2017-07-03 |
| 1194186031 | Clifton Nane Williams | Counselor | 3230 Hampton Circle, Augusta, GA 30906 | 2016-03-18 |
| 1376929661 | Catherine A. Ganzy | Social Worker | 3405 Mike Padgett Highway; Building 201, East Central Regional Hosptial, Augusta, GA 30906 | 2015-08-10 |
| 1962810358 | Fatemeh Azadeh Paziraei | Dentist | 1631 Gordon Highway, Augusta Smiles Youth Dentistry, Augusta, GA 30906 | 2014-07-29 |
| 1568809770 | Brandon Jennings | Occupational Therapy Assistant | 2388 Old Mcduffie Rd, Augusta, GA 30906 | 2013-05-29 |
| 1811266646 | Eddie P Johnson IIi, Dmd, PC | Preferred Provider Organization | 2755 Barton Chapel Rd, Augusta, GA 30906 | 2011-12-23 |
| 1366739021 | Kerensa A Cooks | Registered Nurse | 3421 Mike Padgett Highway, Serenity Behavioral Health Systems, Augusta, GA 30906 | 2011-07-01 |
| 1265737423 | Pidcock Chiropractic, Inc. | Chiropractor | 3028 Peach Orchard Rd., Augusta, GA 30906 | 2011-01-20 |
| Find all providers in zip 30906 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598380842 | David Reynolds Cromer | Internal Medicine | 528 Walden Hills Ct, Augusta, GA 30909-0225 | 2020-06-12 |
| 1114542305 | Graham Skelton | Internal Medicine | 1480 Wrightsboro Rd Apt 6104, Augusta, GA 30901-3274 | 2020-06-12 |
| 1487278909 | Robert Kennedy | Internal Medicine | Augusta University Internal Medicine Residency Program, 1120 15th Street, Bi 5070, Augusta, GA 30912 | 2020-06-01 |
| 1467015628 | Adam Nikolas Davis | Internal Medicine | 1120 5th St, Augusta, GA 30912-0001 | 2019-04-15 |
| 1528621661 | Chadwick Scott Fitzgerald | Internal Medicine | 1459 Laney Walker Blvd Ste Ae3042, Augusta, GA 30912-0002 | 2019-04-15 |
| 1003379280 | Kayla Cox | Internal Medicine | 1120 15th St Bi5070, Augusta, GA 30912 | 2019-04-13 |
| 1326501560 | Awlad Hossain Bhuiyan | Internal Medicine | 120 15th St, Augusta, GA 30912-0001 | 2019-04-12 |
| 1033601315 | Mohammad Umair Azam | Internal Medicine | 1120 15th St # Bi5070, Augusta, GA 30912-0004 | 2018-06-03 |
| 1942732334 | Jennifer Espinal | Internal Medicine | 3651 Wheeler Rd Ofc, Augusta, GA 30909-6521 | 2017-04-03 |
| 1134675564 | Arnab Saha | Internal Medicine | 1120 15 Th St., Augusta, GA 30912 | 2016-08-26 |
| 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.