MR. JAMES V. INTORCIA (NPI# 1417204009) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417204009 |
| Entity Type | Individual |
| Full Name | MR. JAMES V. INTORCIA |
| Credential | A.T. |
| Practice Address |
3708 Northside Dr Macon GA 31210-2404 |
| Practice Telephone | 4787454206 |
| Practice Fax Number | 4782545324 |
| Mailing Telephone | 4787454206 |
| Mailing Fax Number | 4782545324 |
| Enumeration Date | 2012-08-14 |
| Last Update Date | 2012-08-14 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2255A2300X |
Specialist/Technologist Specialization: Athletic Trainer |
AT001915 | GA | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
3708 NORTHSIDE DR |
| City | MACON |
| State | GA |
| Zip Code | 31210-2404 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245236744 | Edward Keith Grant | Physician Assistant | 3708 Northside Dr, Macon, GA 31210-2404 | 2005-06-21 |
| 1295333680 | Daniel Braschler | Physical Therapist | 3708 Northside Dr, Macon, GA 31210-2404 | 2020-10-16 |
| 1881203958 | Bobby Holcumb IIi | Physical Therapy Assistant | 3708 Northside Dr, Macon, GA 31210-2404 | 2020-07-24 |
| 1184240426 | Jenna Walton | Nurse Practitioner | 3708 Northside Dr, Macon, GA 31210-2404 | 2020-06-23 |
| 1710525886 | April Hancock | Physical Therapist | 3708 Northside Dr, Macon, GA 31210-2404 | 2019-12-19 |
| 1942856620 | Natalia Busuttil | Physical Therapist | 3708 Northside Dr, Macon, GA 31210-2404 | 2019-08-17 |
| 1689228918 | Cameron Tidwell | Nurse Practitioner | 3708 Northside Dr, Macon, GA 31210-2404 | 2019-07-25 |
| 1255892600 | Joshua Beagle | Physical Therapist | 3708 Northside Dr, Macon, GA 31210-2404 | 2019-03-28 |
| 1629536776 | Mayur Vishnubhai Patel | Physical Therapist | 3708 Northside Dr, Macon, GA 31210-2404 | 2019-03-07 |
| 1043776891 | Lauren Clark | Nurse Practitioner | 3708 Northside Dr, Macon, GA 31210-2404 | 2019-02-18 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033743455 | Dana Elizabeth Toth | Nurse Practitioner | 5300 Bowman Rd, Macon, GA 31210 | 2020-02-25 |
| 1871124735 | Jessica Bello | Nurse Practitioner | 5300 Bowman Road, Macon, GA 31210 | 2020-01-30 |
| 1225505787 | Rebekah Hollinshead | Occupational Therapist | Therapy Specialists of Georgia, 4116 Arkwright Road, Macon, GA 31210 | 2018-11-01 |
| 1346744943 | Ace Medical Transport LLC. | Ambulance | 728 Gay Dr, Macon, GA 31210 | 2018-03-20 |
| 1972965226 | Omar Faruk Ahmad | Family Medicine | 3400 Riverside Drvie, Macon, GA 31210 | 2016-03-25 |
| 1083074868 | Macon Dentist Office, PC | Dentist | 206 Tom Hill Sr Blvd, Suite 106, Macon, GA 31210 | 2016-03-07 |
| 1992176952 | Kerisia Wasztyl | Marriage & Family Therapist | 4691 Pine Valley Dr, Macon, GA 31210 | 2015-10-15 |
| 1073905444 | Eunice Malave De Leon | Social Worker | 174 Spring St, Macon, GA 31210 | 2015-02-23 |
| 1396141545 | Axis Surgery Center LLC | Clinic/Center | 230 Sheraton Blvd, Ste B, Macon, GA 31210 | 2014-11-17 |
| 1073914115 | Monique Rechelle Delay Moore | Community/Behavioral Health | 646 Millrun Court, Macon, GA 31210 | 2014-09-09 |
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| Taxonomy Code | 2255A2300X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Specialist/Technologist |
| Specialization | Athletic Trainer |
| Athletic trainers are allied health care professionals who work in consultation with or under the direction of physicians, and specialize in the prevention, assessment, treatment and rehabilitation of injuries and illnesses. Currently, the entry-level employment requirements are a bachelor’s degree with a major in athletic training from an accredited university or college. A majority of athletic trainers hold advanced degrees. National board certification is generally required as a condition of state licensure and employment. Most states regulate athletic trainers, and they practice within the scope of that license or regulation. Clinical practice includes emergency care, rehabilitation, reconditioning, therapeutic exercise, wellness programs, exercise physiology, kinesiology, biomechanics, nutrition, psychology and health care administration. |
| Notes: Source: National Athletic Trainers’ Association (www.NATA.org) [1/1/2006: modified definition, modified source] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669004693 | Andrew Jeremy Mariscal | Specialist/Technologist | 1045 Ashford Chase Ct, Macon, GA 31210-8027 | 2020-02-07 |
| 1558993535 | Kathryn E Curtin | Specialist/Technologist | 4150 Arkwright Rd Apt 60, Macon, GA 31210-1727 | 2020-02-07 |
| 1316583644 | Jazmine Nichole Washington | Specialist/Technologist | 3960 Dorothy Dr, Macon, GA 31217-5426 | 2019-11-21 |
| 1336701325 | Marissa Ashley Hatem | Specialist/Technologist | 296 Orange St Apt 5, Macon, GA 31201-1688 | 2019-07-01 |
| 1043794258 | Hunter Leigh Martin | Specialist/Technologist | 127 Saint Croix Dr, Macon, GA 31210-8605 | 2018-09-24 |
| 1093227282 | Peyton Kayley M'lyn Braunstein | Specialist/Technologist | 233 Chadwick Cir, Macon, GA 31210-8836 | 2017-10-29 |
| 1164898771 | Stephanie Luecke Schneider | Specialist/Technologist | 1111 Valley View Ct, Macon, MO 63552-2128 | 2015-08-18 |
| 1124409883 | Ryan Stuart | Specialist/Technologist | 1300 Coleman Ave, Macon, GA 31207-4642 | 2015-06-17 |
| 1174925416 | William Holcomb | Specialist/Technologist | 1501 Mercer University Drive Mercer University, Macon, GA 31207-0001 | 2014-09-18 |
| 1205236635 | Amanda Windon | Specialist/Technologist | 851 Orange St, Macon, GA 31201-2164 | 2014-09-04 |
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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.