KYLE GUDERIAN (NPI# 1508491812) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508491812 |
| Entity Type | Individual |
| Full Name | KYLE GUDERIAN |
| Credential | NP |
| Practice Address |
1350 Walton Way Augusta GA 30901-2612 |
| Mailing Address |
213 Hunts Landing Dr Kathleen GA 31047-4125 |
| Practice Telephone | 7067229011 |
| Mailing Telephone | 4782350963 |
| Enumeration Date | 2020-03-06 |
| Last Update Date | 2020-08-19 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
RN258791 | GA | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | GEORGIA NURSING BOARD | RN258791 | 01 |
| Street Address |
1350 WALTON WAY |
| City | AUGUSTA |
| State | GA |
| Zip Code | 30901-2612 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811993926 | Mary Jo Goolsby | Nurse Practitioner | 1350 Walton Way, Augusta, GA 30901-2612 | 2005-06-23 |
| 1750989810 | Trang Khanh Nguyen | Nurse Practitioner | 1350 Walton Way, Augusta, GA 30901-2629 | 2020-10-12 |
| 1245842152 | Margaret Anne Rossi | Registered Nurse | 1350 Walton Way, Augusta, GA 30901-2612 | 2020-08-21 |
| 1003445313 | Sarika Mishra | Registered Nurse | 1350 Walton Way, Augusta, GA 30901-2612 | 2020-04-07 |
| 1982246070 | Aisha Ford | Registered Nurse | 1350 Walton Way, Augusta, GA 30901-2612 | 2019-10-10 |
| 1588214977 | Alexander S Elsen | Physical Medicine & Rehabilitation | 1350 Walton Way, Augusta, GA 30901-2629 | 2019-09-17 |
| 1215599527 | Sherwin Goering | Nurse Practitioner | 1350 Walton Way, Augusta, GA 30901-2612 | 2019-07-08 |
| 1417418807 | Christopher Brandon Walker | Student in an Organized Health Care Education/Training Program | 1350 Walton Way, Augusta, GA 30901-2612 | 2019-03-27 |
| 1205309333 | Rachel Ann Shaver | Registered Nurse | 1350 Walton Way, Augusta, GA 30901-2629 | 2019-01-11 |
| 1578038915 | Lisa Rene'e Carpenter | Nurse Practitioner | 1350 Walton Way, Augusta, GA 30901-2629 | 2018-10-12 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477019925 | Courtney Erin Fairchild | Physician Assistant | 1101 15th Street, Pa-224, Augusta, GA 30901 | 2019-02-20 |
| 1699263921 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 1022 Walton Way Spc C, Augusta, GA 30901 | 2018-04-23 |
| 1235684192 | Heather Raborn | Allergy & Immunology | 1350 Walton Way Ste 5100, Augusta, GA 30901 | 2016-08-22 |
| 1457690745 | Rehab Without Walls, Inc. | In Home Supportive Care | 820 St Sebastin Way Se, Augusta, GA 30901 | 2013-02-06 |
| 1861788051 | Christina Weidner Belcher | Physical Therapist | 1246 Pine St, Augusta, GA 30901 | 2011-06-25 |
| 1750695979 | C H Martin Company | Durable Medical Equipment & Medical Supplies | 1456 Walton Way Suite B, Augusta, GA 30901 | 2010-07-29 |
| 1366773905 | Csb of East Central Ga | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 4027 Wheeler Rd, Augusta, GA 30901 | 2010-01-21 |
| 1851622484 | Csb of East Central Ga | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1715 Forest Drive, Augusta, GA 30901 | 2010-01-21 |
| 1760615280 | Absolute Family PCh | Point of Service | 2035 Old Savannah Rd., Augusta, GA 30901 | 2009-09-01 |
| 1073740643 | Ryan J Altenburg | Internal Medicine | 820 Saint Sebastian Way Ste 8a, Augusta, GA 30901 | 2009-06-22 |
| Find all providers in zip 30901 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558962894 | Anna Marie Kodama | Nurse Practitioner | 462 Furys Ferry Rd # C, Augusta, GA 30907-9506 | 2020-11-03 |
| 1588262372 | Taylor Safford | Nurse Practitioner | 1348 Walton Way Ste 4100, Augusta, GA 30901-5107 | 2020-10-13 |
| 1831719269 | Tanaysa Green | Nurse Practitioner | 1702 Holly Hill Rd, Augusta, GA 30904-5050 | 2020-04-27 |
| 1699395749 | Mary Elizabeth Dalis | Nurse Practitioner | 1025 Redbird Rd, Augusta, GA 30904-3181 | 2020-04-18 |
| 1316585185 | Rebecca Williford | Nurse Practitioner | 1220 George C Wilson Dr, Augusta, GA 30909-4501 | 2019-12-12 |
| 1699322370 | Ashley Staten | Nurse Practitioner | 2739 Huntcliffe Dr, Augusta, GA 30909-0662 | 2019-08-19 |
| 1053978205 | Keneka V Allen | Nurse Practitioner | 6229 Key West Dr, Augusta, GA 30909-6745 | 2019-05-23 |
| 1487210589 | Jason Schunk | Nurse Practitioner | S7645 Morning Crest Dr, Augusta, WI 54722-7579 | 2019-05-14 |
| 1740754308 | Patricia Lynn Blevins | Nurse Practitioner | 300 E Hospital Dr, Augusta, GA 30905 | 2019-01-17 |
| 1174097190 | Yuri Kang | Nurse Practitioner | Augusta University Medical Center 1120 15th Street, Augusta, GA 30912-0359 | 2019-01-12 |
| Find all providers in AUGUSTA | ||||
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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.