CLINTON S. BEVERLY MD PC (NPI# 1346311719) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1346311719 |
| Entity Type | Organization |
| Organization Name | CLINTON S. BEVERLY MD PC |
| Practice Address |
440 Charter Blvd Suite 3302 Macon GA 31210-4857 |
| Mailing Address |
Po Box 4047 Macon GA 31208-4047 |
| Practice Telephone | 4784773112 |
| Practice Fax Number | 4784774840 |
| Mailing Telephone | 4784773112 |
| Mailing Fax Number | 4784774840 |
| Enumeration Date | 2006-11-10 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. CLINTON S BEVERLY (OWNER) |
| Authorized Official Telephone | 4784773112 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208600000X | Surgery | GA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | RAIL ROAD MEDICARE GRP # | DC0201 | 01 |
| Street Address |
440 CHARTER BLVD SUITE 3302 |
| City | MACON |
| State | GA |
| Zip Code | 31210-4857 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780602011 | Consuela Maria Williams-holliday | Podiatrist | 440 Charter Blvd, Ste 2202, Macon, GA 31210-0705 | 2006-07-17 |
| 1659713733 | Grace Family Practice | Family Medicine | 440 Charter Blvd, Suite 3303, Macon, GA 31210-4857 | 2013-07-18 |
| 1114296464 | Billie L. Jackson, M.d., LLC | Dermatology | 440 Charter Blvd, Suite 2201, Macon, GA 31210-0724 | 2011-12-15 |
| 1912205477 | John A Wells Md Pa | Surgery | 440 Charter Blvd, Suite 3302, Macon, GA 31210-4857 | 2011-03-08 |
| 1093860280 | Northside Pharmacy, Inc. | Pharmacist | 440 Charter Blvd, Suite 1107, Macon, GA 31210-4857 | 2007-01-25 |
| 1295892495 | The Total Woman Healthcare Center, P.C. | Obstetrics & Gynecology | 440 Charter Blvd, Suite 2202, Macon, GA 31210-4857 | 2007-01-03 |
| 1235232430 | Billie Luke Jackson | Dermatology | 440 Charter Blvd, Suite 2201, Macon, GA 31210-4857 | 2006-09-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033743455 | Dana Elizabeth Toth | Nurse Practitioner | 5300 Bowman Rd, Macon, GA 31210 | 2020-02-25 |
| 1871124735 | Jessica Bello | Nurse Practitioner | 5300 Bowman Road, Macon, GA 31210 | 2020-01-30 |
| 1225505787 | Rebekah Hollinshead | Occupational Therapist | Therapy Specialists of Georgia, 4116 Arkwright Road, Macon, GA 31210 | 2018-11-01 |
| 1346744943 | Ace Medical Transport LLC. | Ambulance | 728 Gay Dr, Macon, GA 31210 | 2018-03-20 |
| 1972965226 | Omar Faruk Ahmad | Family Medicine | 3400 Riverside Drvie, Macon, GA 31210 | 2016-03-25 |
| 1083074868 | Macon Dentist Office, PC | Dentist | 206 Tom Hill Sr Blvd, Suite 106, Macon, GA 31210 | 2016-03-07 |
| 1992176952 | Kerisia Wasztyl | Marriage & Family Therapist | 4691 Pine Valley Dr, Macon, GA 31210 | 2015-10-15 |
| 1073905444 | Eunice Malave De Leon | Social Worker | 174 Spring St, Macon, GA 31210 | 2015-02-23 |
| 1396141545 | Axis Surgery Center LLC | Clinic/Center | 230 Sheraton Blvd, Ste B, Macon, GA 31210 | 2014-11-17 |
| 1073914115 | Monique Rechelle Delay Moore | Community/Behavioral Health | 646 Millrun Court, Macon, GA 31210 | 2014-09-09 |
| Find all providers in zip 31210 | ||||
| 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 |
|---|---|---|---|---|
| 1063054237 | Stacey M Lowe | Surgery | 146 Wesleyan Way, Macon, GA 31210-4400 | 2019-10-09 |
| 1871058933 | Central Georgia Vascular Solutions | Surgery | 688 Walnut St Ste 201, Macon, GA 31201-0316 | 2019-02-04 |
| 1780103879 | Gurijala Ramesh Ramayya | Surgery | 215 Autumn Trace Ct, Macon, GA 31210-8024 | 2017-09-11 |
| 1881073054 | Andrew Lee Drahos | Surgery | 777 Hemlock St # 140, Macon, GA 31201 | 2015-05-21 |
| 1437594132 | Icu Specialists, LLC | Surgery | 656 Monticlair Dr, Macon, GA 31210-4432 | 2013-05-08 |
| 1164611331 | Hany N Atalah | Surgery | 4801 Oxford Rd, Macon, GA 31210-3039 | 2007-10-23 |
| 1649495870 | William Thomas Carrigan | Surgery | 121 Wolf Creek Dr N, Macon, GA 31210-9002 | 2007-04-14 |
| 1649341033 | Donald W Rhame | Surgery | 700 Spring St, Ste 300, Macon, GA 31201-2146 | 2006-11-10 |
| 1437184306 | John Thomas Williams Iv | Surgery | 870 High St, Macon, GA 31213-0001 | 2006-07-11 |
| 1629002365 | Thomas C Woodyard | Surgery | 330 Hospital Dr Bldg C Ste 315, Macon, GA 31217 | 2006-07-10 |
| Find all providers in MACON | ||||
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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.