DR. MATTHEW ANTHONY THREADGILL (NPI# 1376740977) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376740977 |
| Entity Type | Individual |
| Full Name | DR. MATTHEW ANTHONY THREADGILL |
| Credential | M.D. |
| Practice Address |
1245 Augusta West Pkwy Augusta GA 30909-1807 |
| Practice Telephone | 7068680389 |
| Practice Fax Number | 7066510729 |
| Mailing Telephone | 7068680389 |
| Mailing Fax Number | 7066510729 |
| Enumeration Date | 2007-06-28 |
| Last Update Date | 2010-07-20 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | 002452 | GA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 286300162A | 05 | |
| GA | GA LICENSES | 064081 | 01 |
| GA | RESIDENCY TRAINING PERMIT | 002452 | 01 |
| Street Address |
1245 AUGUSTA WEST PKWY |
| City | AUGUSTA |
| State | GA |
| Zip Code | 30909-1807 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679533160 | Sterling C Newton Jr. | Pediatrics | 1245 Augusta West Pkwy, Augusta, GA 30909-1807 | 2006-03-27 |
| 1588868293 | Barbara Miller Leverett | Pediatrics | 1245 Augusta West Pkwy, Augusta, GA 30909-1807 | 2007-06-14 |
| 1679534762 | Jerry Allan Miller Jr. | Pediatrics | 1245 Augusta West Pkwy, Augusta, GA 30909-1807 | 2006-03-29 |
| 1972564979 | Steven L Moore | Pediatrics | 1245 Augusta West Pkwy, Augusta, GA 30909-1807 | 2006-03-29 |
| 1881655892 | Jennifer Drake | Pediatrics | 1245 Augusta West Pkwy, Augusta, GA 30909-1807 | 2006-03-29 |
| 1114988144 | Jennifer Massey | Pediatrics | 1245 Augusta West Pkwy, Augusta, GA 30909-1807 | 2006-03-29 |
| 1013978048 | Aaron W Hanna | Pediatrics | 1245 Augusta West Pkwy, Augusta, GA 30909-1807 | 2006-03-29 |
| 1275593790 | Augusta Pediatric Associates, P.C. | Pediatrics | 1245 Augusta West Pkwy, Augusta, GA 30909-1807 | 2006-03-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912513888 | Lauran Simpson | Behavior Technician | 1237 Augusta West Parkway, Augusta, GA 30909 | 2020-09-16 |
| 1487273884 | Still Perspectives Counseling LLC | Counselor | 1265 Inerstate Prwy, Suite B, Augusta, GA 30909 | 2020-04-15 |
| 1598397838 | Mjra Medical LLC | Psychologist | 3675 J Dewey Gray Cr Ste 300, Augusta, GA 30909 | 2020-02-05 |
| 1003452319 | Danny Robinson | Counselor | 2609 Commons Boulevard, Augusta, GA 30909 | 2019-11-21 |
| 1407498637 | Candice M Cruse | Social Worker | 2609 Commons Blvd, Augusta, GA 30909 | 2019-10-09 |
| 1902363385 | Mary D Jodon | Pharmacist | 3338 Wrightsboro Rd., Augusta, GA 30909 | 2019-02-21 |
| 1447790514 | Burn Critical Care Associates, LLC | Internal Medicine | 3614 J. Dewey Gray Circle, Bldg B., Augusta, GA 30909 | 2017-03-08 |
| 1124561766 | Sasha Latara Mccraw | Counselor | 7303 Palomino Court, Augusta, GA 30909 | 2016-11-30 |
| 1174974620 | Warren Umansky, Ph.d. | Psychologist | 302 Wheeler Executive Ctr, Augusta, GA 30909 | 2016-06-27 |
| 1811358955 | Theodora Mcleskey | Nurse Practitioner | 1215 George C. Wilson Drive, Augusta, GA 30909 | 2016-03-17 |
| Find all providers in zip 30909 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| 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 Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134745953 | Molly C Shields | Pediatrics | Dugas Building Bg 107 1120 15th Street, Augusta, GA 30912-0001 | 2020-06-17 |
| 1033734918 | Lauren Wooten Smith | Pediatrics | Chog Pediatric Residency Program 1120 15th Street, Augusta, GA 30912-0001 | 2020-06-16 |
| 1487211199 | Ashley Elizabeth Miller | Pediatrics | 1146 Harper Street, Augusta, GA 30912-0001 | 2019-05-29 |
| 1952968737 | Kayla M. Lasota | Pediatrics | 11230 115th St Ae3042, Augusta, GA 30912 | 2019-05-28 |
| 1558824797 | John-david Constantine Bruce | Pediatrics | Dugas Building (bg-1071) 1120 15th Street, Augusta, GA 30912-0001 | 2019-04-12 |
| 1306229182 | Alexander James Eason | Pediatrics | Georgia Regents Medical Ctr, 1120 15th Street, Augusta, GA 30912-0001 | 2015-06-30 |
| 1184945339 | Shannon Nicole Myers | Pediatrics | 3727 Executive Center Dr, Augusta, GA 30907-2398 | 2010-06-22 |
| 1801113386 | Gerard Rubin | Pediatrics | 6 E Chestnut St Ste 310, Augusta, ME 04330-5717 | 2010-04-23 |
| 1013246487 | William Weston IIi | Pediatrics | 93 Bristlecone Ct., Augusta, GA 30909-1861 | 2009-12-15 |
| 1225285372 | Mustafa Musa Nimir | Pediatrics | 1120 15th St Ae-3042, Medical College of Georgia, Augusta, GA 30912-5000 | 2008-08-20 |
| 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.