BRANDON ARCH GLOW (NPI# 1407108756) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407108756 |
| Entity Type | Individual |
| Full Name | BRANDON ARCH GLOW |
| Credential | PA |
| Practice Address |
2709 Meredyth Dr Ste 450 Albany GA 31707-0222 |
| Practice Telephone | 2294461990 |
| Mailing Telephone | 2294461990 |
| Enumeration Date | 2012-10-11 |
| Last Update Date | 2012-10-11 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 006607 | GA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
2709 MEREDYTH DR STE 450 |
| City | ALBANY |
| State | GA |
| Zip Code | 31707-0222 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114919438 | James A. Rooney | Dermatology | 2709 Meredyth Dr, Suite 340, Albany, GA 31707-0222 | 2005-08-23 |
| 1164883831 | Michael Brandon Ross | Physical Therapist | 2709 Meredyth Dr, Albany, GA 31707-0222 | 2016-03-09 |
| 1417377912 | Jordan Knoefler | Family Medicine | 2709 Meredyth Dr, Albany, GA 31707-0222 | 2014-04-23 |
| 1831442888 | Lesa Beach | Nurse Practitioner | 2709 Meredyth Dr, Ste 230, Albany, GA 31707-0222 | 2012-10-16 |
| 1447571294 | Meredith Mckee Koomson | Internal Medicine | 2709 Meredyth Dr, Suite 330, Albany, GA 31707-0222 | 2010-06-16 |
| 1407176647 | Phoebe Neurology | Psychiatry & Neurology | 2709 Meredyth Dr, Ste 230, Albany, GA 31707-0218 | 2010-06-10 |
| 1336261205 | Berg Eye Center, P. C. | Durable Medical Equipment & Medical Supplies | 2709 Meredyth Dr, Suite 110 One Meredyth Place, Albany, GA 31707-0201 | 2007-04-04 |
| 1003974809 | Southwest Georgia Neurology, P.C. | Psychiatry & Neurology | 2709 Meredyth Dr, Suite 230, Albany, GA 31707-0222 | 2006-12-05 |
| 1598859373 | Bridget T Milani | Physical Therapist | 2709 Meredyth Dr, Suite 450, Albany, GA 31707-0222 | 2006-10-03 |
| 1891724985 | Southwest Georgia Orthopedic & Sports Medicine Center, Inc. | Specialist | 2709 Meredyth Dr, Suite 450, Albany, GA 31707-0222 | 2006-07-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396394011 | Barbara Cannon | Technician | 2025 Gail Avenue, Albany, GA 31707 | 2019-09-05 |
| 1669941035 | Wallace Coleman | Counselor | 2403 Osler Court, Suite B, Albany, GA 31707 | 2018-11-15 |
| 1992293955 | Tiffany Timmerman | Massage Therapist | Albany Therapeutic Massage Clinic, 1534 Dawson, Rd, Albany, GA 31707 | 2018-04-25 |
| 1225550957 | Christopher George Solomon | Nurse Practitioner | 2336 Dawson Rd., Urgent Care Center At Phoebe Northwest, Albany, GA 31707 | 2017-07-14 |
| 1689107229 | Teemercare @ Home LLC | Home Health | 1129 Dawson Rd Ste A, Albany, GA 31707 | 2017-04-11 |
| 1205373917 | Nicarro Henderson | Specialist | 2005 E Dawson Rd, Albany, GA 31707 | 2017-01-20 |
| 1235567918 | Restoration of The Minds LLC | Community/Behavioral Health | 1408 Edgerly Avenue, Albany, GA 31707 | 2013-10-16 |
| 1588091334 | Marsha Danell Glover | Pediatrics | 517 N. Westover Blvd., Albany, GA 31707 | 2013-10-10 |
| 1003253139 | Bailey Healthcare Inc | Community/Behavioral Health | 2416 Suite B Westgate Dr, Albany, GA 31707 | 2013-05-30 |
| 1346685666 | Albany Urology Surgery Center LLC | Clinic/Center | 2400 Osler Court, Albany, GA 31707 | 2013-04-30 |
| Find all providers in zip 31707 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023619129 | Anna Leigh Vonck | Physician Assistant | 2 Executive Park Dr Ste 2, Albany, NY 12203-3700 | 2020-11-04 |
| 1407409113 | Morgan Shumway | Physician Assistant | 50 New Scotland Ave # Mc191, Albany, NY 12208-3403 | 2019-07-22 |
| 1588136279 | Christine Ciavarella | Physician Assistant | 405 Kains Ave Ste 205, Albany, CA 94706-1270 | 2018-12-19 |
| 1225503535 | Maura Kathleen Corbett | Physician Assistant | 43 New Scotland Ave Mc-139, Department of Emergency Medicine, Albany, NY 12208-3478 | 2018-10-12 |
| 1669966743 | Kimberly Aebli | Physician Assistant | 47 New Scotland Ave Mc 101, Albany, NY 12208 | 2018-06-21 |
| 1255844643 | Erica Francesca Lari Parks | Physician Assistant | 530 Kinkead Way Apt 205, Albany, CA 94706-2656 | 2017-11-08 |
| 1306376934 | Elisabeth Catherine Henderson | Physician Assistant | 98 Wolf Rd Ste 16, Albany, NY 12205-1226 | 2017-06-15 |
| 1417306374 | Larry James Edwards | Physician Assistant | 2030 Newton Rd, Albany, GA 31701-3520 | 2016-06-10 |
| 1477923019 | Cheyenne Allen Boone | Physician Assistant | 47 New Scotland Ave Mc-139, Albany Medical Center Dept Emergency Medicine, Albany, NY 12208-3412 | 2015-09-25 |
| 1396148300 | Tina Huang | Physician Assistant | 15 Norman Ave, Albany, NY 12203-5005 | 2014-10-03 |
| Find all providers in ALBANY | ||||
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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.