RONALD MALCOLM (NPI# 1407958770) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407958770 |
| Entity Type | Individual |
| Full Name | RONALD MALCOLM |
| Other Name | RON MALCOLM |
| Credential | PA-C |
| Practice Address |
1712-a East Broad Avenue Albany GA 31705 |
| Mailing Address |
204 N Westover Blvd Albany GA 31707-2983 |
| Practice Telephone | 2296393100 |
| Mailing Telephone | 2298886559 |
| Mailing Fax Number | 2294364107 |
| Enumeration Date | 2006-09-05 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 2081 | GA | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | AETNA | 7169366 | 01 |
| Street Address |
1712-A EAST BROAD AVENUE |
| City | ALBANY |
| State | GA |
| Zip Code | 31705 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780608992 | Albany Area Primary Health Care, Inc. | Clinic/Center | 1712-a East Broad Avenue, Albany, GA 31705 | 2006-07-27 |
| 1396849766 | William Mcpeters | Internal Medicine | 1712-a East Broad Avenue, Albany, GA 31705 | 2006-09-07 |
| 1013019363 | Robyn Mann Johnson | Internal Medicine | 1712-a East Broad Avenue, Albany, GA 31705 | 2006-09-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346897410 | Bonnie Scott | Technician | 418 Persimmon Road, Albany, GA 31705 | 2019-08-22 |
| 1265962906 | Shoes and Medical Product Solutions LLC | Durable Medical Equipment & Medical Supplies | 1715 E Oglethorpe Blvd, Albany, GA 31705 | 2017-06-15 |
| 1083156079 | Dianne Lanier | Specialist | 217 Johnson Road Suite C, Albany, GA 31705 | 2016-11-08 |
| 1699225342 | Yolanda Fields | Contractor | 609 Pine Glen Drive, Albany, GA 31705 | 2016-10-06 |
| 1225276272 | Michael Bernard Sanders | Prosthetist | 326 Enterprise Dr., Albany, GA 31705 | 2009-01-29 |
| 1588724223 | Karen Baker | Nurse Practitioner | 213 Old Radium Springs Road, Albany, GA 31705 | 2006-12-11 |
| 1740289545 | Belise Livingston-burns | Pediatrics | 1712-c East Broad Avenue, Albany, GA 31705 | 2005-07-14 |
| 1407950876 | Donna Edmond-king | Pediatrics | 1712-c East Broad Avenue, Albany, GA 31705 | 2006-09-07 |
| 1346265550 | Albany Area Primary Health Care, Inc. | Clinic/Center | 1712-c East Broad Avenue, Albany, GA 31705 | 2006-07-12 |
| 1073146437 | Mishondas Shantel Bogans | Contractor | 1400 Owens Ave, Albany, GA 31705-1019 | 2020-02-13 |
| Find all providers in zip 31705 | ||||
| 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.