TLC OF GEORGIA LLC (NPI# 1386193571) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1386193571 |
| Entity Type | Organization |
| Organization Name | TLC OF GEORGIA LLC |
| Practice Address |
4321 Hartley Bridge Rd Macon GA 31216-5641 |
| Mailing Address |
2620 Elm Hill Pike Nashville TN 37214-3108 |
| Practice Telephone | 4787882046 |
| Practice Fax Number | 4787882047 |
| Mailing Telephone | 6154254200 |
| Mailing Fax Number | 6158915244 |
| Enumeration Date | 2016-09-28 |
| Last Update Date | 2016-12-21 |
| Authorized Official Name | MARC R WATKINS (CMO) |
| Authorized Official Telephone | 6154254200 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363A00000X | Physician Assistant | Physician Assistants & Advanced Practice Nursing Providers | ||
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | GROUP NPI | 1750677241 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164827853 | Tlc of Georgia LLC | Nurse Practitioner | 1931 Jesse Jewell Pkwy, Gainesville, GA 30501-2500 | 2014-10-24 |
| 1396149373 | Tlc of Georgia LLC | Nurse Practitioner | 6001 Cumming Hwy Ste 1, Sugar Hill, GA 30518-6113 | 2014-10-20 |
| 1376095638 | Tlc of Georgia LLC | Nurse Practitioner | 564 Crosstown Dr, Peachtree City, GA 30269-2916 | 2016-11-02 |
| 1447702709 | Tlc of Georgia LLC | Nurse Practitioner | 3094 Watson Blvd, Warner Robins, GA 31093-8500 | 2016-11-02 |
| 1205385119 | Tlc of Georgia LLC | Nurse Practitioner | 800 Glenwood Ave Se, Atlanta, GA 30316-1814 | 2016-10-04 |
| 1114476025 | Tlc of Georgia LLC | Nurse Practitioner | 378 Marketplace Pkwy, Dawsonville, GA 30534-7266 | 2016-10-04 |
| 1225587421 | Tlc of Georgia LLC | Nurse Practitioner | 125 W Main St, Cartersville, GA 30120-3507 | 2016-09-28 |
| 1124407440 | Tlc of Georgia LLC | Nurse Practitioner | 774 Ga Highway 96, Bonaire, GA 31005-3300 | 2015-05-19 |
| 1477945327 | Tlc of Georgia LLC | Nurse Practitioner | 1355 S Park St, Carrollton, GA 30117-4433 | 2015-03-02 |
| 1912399866 | Tlc of Georgia LLC | Nurse Practitioner | 1227 Rockbridge Rd, Stone Mountain, GA 30087-3064 | 2015-03-02 |
| Street Address |
4321 HARTLEY BRIDGE RD |
| City | MACON |
| State | GA |
| Zip Code | 31216-5641 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568496305 | The Kroger Co | Durable Medical Equipment & Medical Supplies | 4321 Hartley Bridge Rd, Macon, GA 31216-5641 | 2006-07-10 |
| 1215560123 | Jennifer Anne Mcculley | Pharmacist | 4321 Hartley Bridge Rd, Macon, GA 31216-5641 | 2020-02-19 |
| 1699306134 | Patrenice Thomas | Pharmacist | 4321 Hartley Bridge Rd, Macon, GA 31216-5641 | 2020-02-03 |
| 1962033308 | Donald Allen Cooper | Pharmacist | 4321 Hartley Bridge Rd, Macon, GA 31216-5641 | 2020-02-03 |
| 1639524002 | Anjanean Jackson | Nurse Practitioner | 4321 Hartley Bridge Rd, Macon, GA 31216-5641 | 2016-05-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578125282 | Georgia Treatment Services | Clinic/Center | 6132 Hawkinsvill Road, Macon, GA 31216 | 2019-07-02 |
| 1720495898 | Erma Wells Heard | Nurse Practitioner | 217 Pendleton Ct., Macon, GA 31216 | 2014-07-21 |
| 1881959518 | Leigh Underwood Bennett | Dentist | 4226 Hartley Bridge Rd Ste 102, Macon, GA 31216 | 2012-07-09 |
| 1295980456 | Georgia Cvs Pharmacy, L.L.C. | Durable Medical Equipment & Medical Supplies | 4585 Hartley Bridge Rd., Macon, GA 31216 | 2008-12-01 |
| 1013083336 | Rutland Medical Supply | Durable Medical Equipment & Medical Supplies | 3035 Hartley Bridge Road, Suite 2, Macon, GA 31216 | 2006-11-28 |
| 1477074318 | Hollie K Bradley | Nurse Practitioner | 4310 Hartley Bridge Rd, Macon, GA 31216 | 2017-06-30 |
| 1104206713 | Hartley Bridge Family Dentistry | Dentist | 4226 Hartley Bridge Rd Ste 102, Macon, GA 31216 | 2015-06-09 |
| 1144432048 | Family Specialty Care LLC | Family Medicine | 4310 Hartley Bridge Rd, Macon, GA 31216 | 2007-05-04 |
| 1164598710 | Kirsten J Hampton | Family Medicine | 4310 Hartley Bridge Rd, Macon, GA 31216 | 2006-11-27 |
| 1063588614 | Cameka N Scarborough | Family Medicine | 4310 Hartley Bridge Rd, Macon, GA 31216 | 2006-11-27 |
| Find all providers in zip 31216 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093315848 | Tracy Tarvers | Nurse Practitioner | 129 Wolf Creek Dr N, Macon, GA 31210-9002 | 2020-10-30 |
| 1578160560 | Ida Mayaka | Nurse Practitioner | 210 Autumn Trace Ct, Macon, GA 31210-8025 | 2020-10-03 |
| 1427664465 | Shanna Lynn Beaulieu | Nurse Practitioner | 781 Spring St Ste 230, Macon, GA 31201-2185 | 2020-09-16 |
| 1467070557 | Raquel Simmons | Nurse Practitioner | 670 Ivy Brook Way, Macon, GA 31210-5520 | 2020-07-06 |
| 1174159800 | Jamie K Polk | Nurse Practitioner | 3951 Ridge Ave Ste C, Macon, GA 31210-5064 | 2020-03-13 |
| 1033743455 | Dana Elizabeth Toth | Nurse Practitioner | 5300 Bowman Rd, Macon, GA 31210 | 2020-02-25 |
| 1730730581 | Lindsay Fernandez | Nurse Practitioner | 102 Saint Johns Pl, Macon, GA 31210-8606 | 2019-09-24 |
| 1003468240 | Skylar Nelson | Nurse Practitioner | 330 Hospital Dr Ste 200, Macon, GA 31217-8034 | 2019-07-09 |
| 1861051880 | Courtney Elizabeth Avery | Nurse Practitioner | 540 Charter Blvd Ste 400, Macon, GA 31210-4882 | 2019-06-12 |
| 1376101196 | Detra K Dixon | Nurse Practitioner | 227 Amalie Dr, Macon, GA 31220-2667 | 2019-06-05 |
| 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.