PATHOLOGISTS AT RIVERDALE (NPI# 1356898506) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356898506 |
| Entity Type | Organization |
| Organization Name | PATHOLOGISTS AT RIVERDALE |
| Other Organization Name | PATHOLOGISTS AT RIVERDALE, PC |
| Practice Address |
11 Upper Riverdale Rd Sw Riverdale GA 30274-2615 |
| Mailing Address |
5755 Hoover Blvd Tampa FL 33634-5340 |
| Practice Telephone | 8134907206 |
| Practice Fax Number | 8138866655 |
| Mailing Telephone | 8134907206 |
| Mailing Fax Number | 8138866655 |
| Enumeration Date | 2016-09-06 |
| Last Update Date | 2016-09-06 |
| Authorized Official Name | DR. MARIO S GONZALEZ (PRESIDENT) |
| Authorized Official Telephone | 8134907206 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207ZP0102X |
Pathology Specialization: Anatomic Pathology & Clinical Pathology |
20216 | GA | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Pathologists at Riverdale, PC | Other Name - Individual/Organization |
| Street Address |
11 UPPER RIVERDALE RD SW |
| City | RIVERDALE |
| State | GA |
| Zip Code | 30274-2615 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831190958 | Southern Regional Health System, Inc | General Acute Care Hospital | 11 Upper Riverdale Rd Sw, Riverdale, GA 30274-2615 | 2005-08-10 |
| 1639796212 | Georgia Em-i Medical Service PC | Physician Assistant | 11 Upper Riverdale Rd Sw, Riverdale, GA 30274-2615 | 2020-06-30 |
| 1093331308 | Harmony Grove Emergency Physicians LLC | Emergency Medicine | 11 Upper Riverdale Rd Sw, Riverdale, GA 30274-2615 | 2020-06-23 |
| 1366092827 | Evan Chandler Burrowes | Dietitian, Registered | 11 Upper Riverdale Rd Sw, Riverdale, GA 30274-2615 | 2019-09-17 |
| 1932676681 | Ashley Lauren King | Physician Assistant | 11 Upper Riverdale Rd Sw, Riverdale, GA 30274-2615 | 2018-10-31 |
| 1518440254 | Prime Healthcare Foundation - Southern Regional, LLC | Psychiatric Unit | 11 Upper Riverdale Rd Sw, Riverdale, GA 30274-2615 | 2018-09-10 |
| 1730660093 | Virginia Tittle Kee | Nurse Practitioner | 11 Upper Riverdale Rd Sw, Riverdale, GA 30274-2615 | 2018-08-24 |
| 1245724723 | Kelly Henry | Registered Nurse | 11 Upper Riverdale Rd Sw, Riverdale, GA 30274 | 2018-06-19 |
| 1053821777 | Angelyn Levell-smith | Nurse Practitioner | 11 Upper Riverdale Rd Sw, Riverdale, GA 30274-2615 | 2017-10-08 |
| 1932625548 | Lpp of Georgia LLC | Emergency Medicine | 11 Upper Riverdale Rd Sw, Riverdale, GA 30274-2615 | 2017-08-15 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245862507 | Todd L. Reed | Chiropractor | 83 Upper Riverdale Rd, Riverdale, GA 30274 | 2020-02-05 |
| 1487135992 | Freddie L Sallette IIi | Technician, Pathology | 385 Brookview Dr, Riverdale, GA 30274 | 2018-08-22 |
| 1366933210 | Dawn A. Paul | Nurse Practitioner | 238 Professional Ct Ste A, Riverdale, GA 30274 | 2018-05-27 |
| 1851894588 | Absolute Health Family & Urgent Care Clinic | Clinic/Center | 7574 Ga 85, Riverdale, GA 30274 | 2018-03-08 |
| 1366972127 | Jamillah Ingram | Physical Therapy Assistant | 315 Upper Riverdale Rd., Riverdale, GA 30274 | 2017-06-14 |
| 1114456514 | Grace L Kelson | Licensed Practical Nurse | 9142 Clubhouse Dr, Riverdale, GA 30274 | 2017-06-08 |
| 1790167799 | Cristian Carbuccia | Internal Medicine | 33 Upper Riverdale Rd Sw Ste 10, Riverdale, GA 30274 | 2015-06-25 |
| 1265857692 | Right Choice Enterprises LLC | Technician | 638 Sterling Ct, Riverdale, GA 30274 | 2014-02-21 |
| 1942571625 | Lowes Guardian Angel LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 7056 Eunice Dr., Riverdale, GA 30274 | 2012-01-26 |
| 1508134156 | Education System Management, Inc | Social Worker | 125 Highway 138, Riverdale, GA 30274 | 2011-12-12 |
| Find all providers in zip 30274 | ||||
| Taxonomy Code | 207ZP0102X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pathology |
| Specialization | Anatomic Pathology & Clinical Pathology |
| A pathologist deals with the causes and nature of disease and contributes to diagnosis, prognosis and treatment through knowledge gained by the laboratory application of the biologic, chemical and physical sciences. A pathologist uses information gathered from the microscopic examination of tissue specimens, cells and body fluids, and from clinical laboratory tests on body fluids and secretions for the diagnosis, exclusion and monitoring of disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added, 7/1/2009: definition reformatted] Additional Resources: American Board of Pathology, 2007. http://www.abpath.org/ This taxonomy code identifies the combined anatomic pathology & clinical pathology route. Board certification for Medical Doctors (MDs) is provided by the American Board of Pathology. To acknowledge the diverse activities in the practice of pathology and to accommodate the interests of individuals wanting to enter the field, the ABP offers primary certification through the following three routes: combined anatomic pathology and clinical pathology, anatomic pathology only and clinical pathology only. Primary certification in anatomic pathology or clinical pathology may be combined with some of the subspecialty certifications. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396776084 | Zoya Kvitash Arbiser | Pathology | Department of Pathology/southern Regional Medical Cente, 11 Upper Riverdale Rd, Riverdale, GA 30274 | 2006-07-05 |
| 1811286446 | Laleh Ehsani | Pathology | 11 Upper Riverdale Rd Sw, Riverdale, GA 30274-2615 | 2011-04-05 |
| 1972815785 | Anthony Simms II | Pathology | 11 Upper Riverdale Rd Sw, Pathology Dept, Riverdale, GA 30274-2615 | 2010-07-09 |
| 1316183031 | Christopher Michael Campo | Pathology | 11 Upper Riverdale Rd Sw, Riverdale, GA 30274-2615 | 2008-12-30 |
| 1851308225 | Shourong Zhao | Pathology | 11 Upper Riverdale Rd Sw, Pathology Dept, Riverdale, GA 30274-2615 | 2006-08-01 |
| 1699737163 | Harold P Brusman | Pathology | 11 Upper Riverdale Rd Sw, Path Dept, Riverdale, GA 30274-2615 | 2006-04-03 |
| 1124098470 | Nancy Elizabeth Newton | Pathology | 11 Upper Riverdale Rd Sw, Riverdale, GA 30274-2615 | 2006-01-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255957148 | Thomas E Cotter | Pathology | 1120 15th St # Bf-103b, Augusta, GA 30912-0004 | 2020-06-17 |
| 1386269835 | Pramila Pallikkappara Moideen | Pathology | Augusta University Medical Center Room Bf-103-b, Augusta, GA 30912-0001 | 2020-06-10 |
| 1558921973 | Anna Nielsen Walker | Pathology | Mercer University School of Medicine Dept of Pathology, Macon, GA 31207-0001 | 2019-06-18 |
| 1437678950 | Thomas William Stewart Jr. | Pathology | 3138 Marthasville Court, Gainesville, GA 30506 | 2017-09-15 |
| 1700225760 | Robert John Nelms Jr. | Pathology | 107 Fairway Dr, Moultrie, GA 31768-6823 | 2013-06-22 |
| 1750725099 | Charles Jacob Stoudenmire | Pathology | 507 W 3rd Ave Ste 7, Albany, GA 31701 | 2013-04-17 |
| 1902143589 | Lindsey Oreita Lowder | Pathology | 1968 Peachtree Rd Nw Bldg 774th, Atlanta, GA 30309-1281 | 2013-01-15 |
| 1184918476 | Stephen Alan Dayan | Pathology | 830 Johns Landing Way, Lawrenceville, GA 30045-6369 | 2011-06-03 |
| 1760793673 | Andrew Erling Johnsen | Pathology | 3248 Avalon Pkwy, Conyers, GA 30013-6320 | 2010-06-24 |
| 1497066518 | Charles Omar Wilson Jr. | Pathology | 175 Samaritan Way, Jasper, GA 30143 | 2010-06-23 |
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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.