MR. ALEXANDER J SHUPP (NPI# 1457740664) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457740664 |
| Entity Type | Individual |
| Full Name | MR. ALEXANDER J SHUPP |
| Credential | PA |
| Practice Address |
3650 Steve Reynolds Blvd Kaiser Permanente Gwinnett Comprehensive Medical Center Duluth GA 30096 |
| Mailing Address |
3495 Piedmont Road, Ne Nine Piedmont Center Atlanta GA 30305 |
| Practice Telephone | 7709316012 |
| Mailing Telephone | 4045045678 |
| Enumeration Date | 2015-01-12 |
| Last Update Date | 2017-03-17 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 7471 | GA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
3650 STEVE REYNOLDS BLVD KAISER PERMANENTE GWINNETT COMPREHENSIVE MEDICAL CENTER |
| City | DULUTH |
| State | GA |
| Zip Code | 30096 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831194893 | Barbara Joan Kell | Nurse Practitioner | 3650 Steve Reynolds Blvd, Duluth, GA 30096-4506 | 2005-06-16 |
| 1750906715 | Grace Elizabeth Mason | Nurse Practitioner | 3650 Steve Reynolds Blvd, Duluth, GA 30096-4506 | 2020-06-15 |
| 1881181584 | Cynthia Denise Humenic | Nurse Practitioner | 3650 Steve Reynolds Blvd, Duluth, GA 30096-4506 | 2018-04-18 |
| 1194230540 | Jenna Dannenbaum | Nurse Practitioner | 3650 Steve Reynolds Blvd, Duluth, GA 30096-4506 | 2017-12-07 |
| 1568994135 | Yolanda Gray-rozier | Registered Nurse | 3650 Steve Reynolds Blvd, Duluth, GA 30096-4506 | 2017-04-01 |
| 1306394655 | Carlie Lynne Adams | Dietitian, Registered | 3650 Steve Reynolds Blvd, Duluth, GA 30096-4506 | 2016-09-15 |
| 1114379757 | Miriam Abouelnasr Gomes | Physician Assistant | 3650 Steve Reynolds Blvd, Duluth, GA 30096-4506 | 2016-07-07 |
| 1699158584 | Ann Whitaker | Dietitian, Registered | 3650 Steve Reynolds Blvd, Duluth, GA 30096-4506 | 2015-07-09 |
| 1548643968 | Paula Gilman | Dietitian, Registered | 3650 Steve Reynolds Blvd, Duluth, GA 30096-4506 | 2015-07-02 |
| 1750763173 | Emily Kim | Internal Medicine | 3650 Steve Reynolds Blvd, Duluth, GA 30096-4506 | 2015-06-22 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922615897 | Georgia Eye Optical, LLC | Ophthalmology | 3800 Pleasant Hill Rd Ste 3, Duluth, GA 30096 | 2020-09-25 |
| 1568090868 | Positive Behavior Services, Inc | Behavior Technician | 3765 Crestwood Pkwy Nw, Duluth, GA 30096 | 2020-03-31 |
| 1861031940 | Elizabeth Ashley Edouard | Counselor | 3464 Duluth Hwy 120, Duluth, GA 30096 | 2020-01-06 |
| 1245701044 | Kathryn Irene Vaughn | Social Worker | 3968 Mainsail Court, Duluth, GA 30096 | 2018-12-06 |
| 1083184626 | Aica Orthopedics, P.C. | Orthopaedic Surgery | 3775 Venture Drive Bldg F, Duluth, GA 30096 | 2018-11-27 |
| 1245709799 | Positive Impact Health Centers, Inc. | Pharmacy | 3350 Breckinridge Blvd, Suite 200a, Duluth, GA 30096 | 2018-11-14 |
| 1235611724 | Katherine Winstead Knott | Counselor | 3460 Summit Ridge Parkway, Suite 503, Duluth, GA 30096 | 2018-08-31 |
| 1710467857 | Envision Optics LLC | Optometrist | 1943 Pleasant Hill Rd, Duluth, GA 30096 | 2018-08-17 |
| 1104314202 | Erin Mckernan Scupham | Chiropractor | 3820 Pleasant Hill Rd. Ne, Suite 4, Duluth, GA 30096 | 2018-04-25 |
| 1053839456 | Rogers Bridge Pediatric Therapy, LLC | Clinic/Center | 2845 Summercrest Ln, Duluth, GA 30096 | 2017-09-06 |
| Find all providers in zip 30096 | ||||
| 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 |
|---|---|---|---|---|
| 1699396622 | Sarah Cheeney | Physician Assistant | 2803 E 8th St, Duluth, MN 55812-1518 | 2020-04-30 |
| 1144841552 | Jake L Mcgraw | Physician Assistant | 2006 N 51st Ave E, Duluth, MN 55804-1251 | 2020-04-27 |
| 1053931451 | Maggie Ferguson | Physician Assistant | 4219 Mcculloch St, Duluth, MN 55804-1934 | 2020-04-26 |
| 1174143093 | Melissa Dybvig | Physician Assistant | 825 N 43rd Ave E, Duluth, MN 55804-1939 | 2020-04-21 |
| 1033667266 | Wossen Adinew Asfaw | Physician Assistant | 3575 Koger Blvd Ste 116, Duluth, GA 30096-7559 | 2016-09-16 |
| 1629457981 | David John Willard | Physician Assistant | 4245 Pleasant Hill Rd, Duluth, GA 30096-6332 | 2015-05-20 |
| 1992065973 | Esther Maria Laucirica | Physician Assistant | 2159 Wynnton Point, Duluth, GA 30097 | 2012-05-23 |
| 1033419155 | Danielle Jackson | Physician Assistant | 1845 Satellite Blvd Nw, Duluth, GA 30097-5256 | 2010-10-22 |
| 1811202534 | Sharon Alston | Physician Assistant | 1580 Boggs Rd, 700, Duluth, GA 30096-1229 | 2010-08-18 |
| 1942496112 | Caroline A Woods | Physician Assistant | 32 E 1st St, Womens Health Ctr, Duluth, MN 55802 | 2007-09-20 |
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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.