NICHOLE GUDGEON (NPI# 1508316647) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508316647 |
| Entity Type | Individual |
| Full Name | NICHOLE GUDGEON |
| Credential | PA-C |
| Practice Address |
900 N Austin Ave Ste 105 Georgetown TX 78626-4349 |
| Practice Telephone | 5129307828 |
| Mailing Telephone | 5129307828 |
| Enumeration Date | 2016-10-13 |
| Last Update Date | 2020-07-29 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | PA13699 | TX | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363A00000X | Physician Assistant | 7448 | AZ | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363A00000X | Physician Assistant | 2018004237 | MO | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363A00000X | Physician Assistant | 2613 | SC | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 608 Old Route 66, Saint Robert, MO 655843730 | 5733365100 | |
| 535 E Mckellips Rd Ste 101, Mesa, AZ 85203 | 4808447400 |
| Street Address |
900 N AUSTIN AVE STE 105 |
| City | GEORGETOWN |
| State | TX |
| Zip Code | 78626-4349 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932603230 | Danietra Mcgrue | Home Health Aide | 108 Blue Waterleaf Ln, Georgetown, TX 78626 | 2018-03-21 |
| 1588175673 | Kristin Marie Alaniz | Nurse Practitioner | 2112 Sw H K Dodgen Loop, Suite 110, Georgetown, TX 78626 | 2017-10-17 |
| 1669865275 | Stephen Harris | Counselor | 101 W Cooperative Way Ste 100, Georgetown, TX 78626 | 2015-03-07 |
| 1356739080 | Craig Crossman | Physical Therapy Assistant | 705 E 13th St, Georgetown, TX 78626 | 2015-01-05 |
| 1679977318 | Nancy Krenek | Physical Therapist | 2050 Rockride Ln., Georgetown, TX 78626 | 2014-10-09 |
| 1275956807 | Georgetown Behavioral Health Institute, LLC | Psychiatric Hospital | 3101 S. Austin Avenue, Georgetown, TX 78626 | 2014-02-03 |
| 1184056954 | Rock Springs, LLC | Psychiatric Hospital | 700 Southeast Inner Loop, Georgetown, TX 78626 | 2013-08-05 |
| 1447691936 | Brandon Michael Hoffman | Dentist | 1821 Westinghouse Road, Suite 1130, Georgetown, TX 78626 | 2013-07-11 |
| 1235422932 | Erica Marie Edgington | Nurse Anesthetist, Certified Registered | Westlake Anesthesia Group, Pa, 1004 South Rock Street, Georgetown, TX 78626 | 2011-05-27 |
| 1356570907 | Grace Salone | Optometrist | 950 W University Ave Ste 108, Georgetown, TX 78626 | 2009-07-03 |
| Find all providers in zip 78626 | ||||
| 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 |
|---|---|---|---|---|
| 1548734072 | Triple A Surgical Assistants, Pllc | Physician Assistant | 723 W University Ave # 301, Georgetown, TX 78626-6607 | 2019-01-17 |
| 1134631450 | Meredith Rollins Hatcher | Physician Assistant | 204 S Interstate I-35, Suite 103, Georgetown, TX 78628 | 2017-10-26 |
| 1487178299 | Heath Martin Gibson | Physician Assistant | 1138 Lexington Rd Ste 140, Georgetown, KY 40324-9672 | 2017-08-02 |
| 1922468370 | Caryn Michelle Mosier | Physician Assistant | 1509 Naranjo Dr, Georgetown, TX 78628-4007 | 2016-02-28 |
| 1265783989 | Virginia Irene Magee | Physician Assistant | 28 Londonderry Ln, Georgetown, MA 01833-2312 | 2012-09-20 |
| 1033435656 | Amanda Marie Moore | Physician Assistant | 8 N Race St, Georgetown, DE 19947 | 2010-04-08 |
| 1245441179 | Holly M Mayer | Physician Assistant | 1150 Lexington Rd Ste 102, Georgetown, KY 40324 | 2007-05-24 |
| 1952515926 | Mercedes Banigan | Physician Assistant | 4426 Williams Drive, Georgetown, TX 78628-1341 | 2007-05-09 |
| 1972569747 | Julia L. Pickel | Physician Assistant | 1904 Railroad St, Georgetown, TX 78626-7718 | 2006-04-21 |
| 1780658930 | Dorian K Shevitz | Physician Assistant | 900 N Austin Ave, Suite 105, Georgetown, TX 78626-4345 | 2006-02-15 |
| Find all providers in GEORGETOWN | ||||
| City | GEORGETOWN |
| Zip Code | 78626 |
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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.