ELIZABETH P BLACKWOOD (NPI# 1528353364) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1528353364 |
| Entity Type | Individual |
| Full Name | ELIZABETH P BLACKWOOD |
| Other Name | ELIZABETH PANGMAN |
| Credential | NP |
| Practice Address |
3950 Austell Rd Austell GA 30106-1121 |
| Mailing Address |
5665 New Northside Dr Nw Suite 320 Atlanta GA 30328-5831 |
| Practice Telephone | 7707327000 |
| Mailing Telephone | 7708745468 |
| Mailing Fax Number | 7708745469 |
| Enumeration Date | 2011-06-09 |
| Last Update Date | 2011-06-09 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | RN144610 | GA | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780295287 | Elizabeth Blackwood | Social Worker | 1005 Sw Disk Dr Ste 104, Bend, OR 97702-3385 | 2020-08-10 |
| 1740463892 | Elizabeth Blackwood | Physical Therapist | 3100 Duraleigh Rd Ste 100, Raleigh, NC 27612-8105 | 2007-12-12 |
| Street Address |
3950 AUSTELL RD |
| City | AUSTELL |
| State | GA |
| Zip Code | 30106-1121 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417951369 | Olatunde Idowu | Internal Medicine | 3950 Austell Rd, Box 22, Austell, GA 30106-1121 | 2005-06-09 |
| 1962001834 | Camille Patrice Mckenzie-brown | Nurse Practitioner | 3950 Austell Rd, Austell, GA 30106-1121 | 2020-10-22 |
| 1508487018 | Michelle Taylor Marbury | Pharmacist | 3950 Austell Rd, Austell, GA 30106-1121 | 2020-05-06 |
| 1477174605 | Alexandra Kamman | Physical Therapist | 3950 Austell Rd, Austell, GA 30106-1121 | 2020-04-28 |
| 1023637923 | Lauren Davison Warren | Registered Nurse | 3950 Austell Rd, Austell, GA 30106-1121 | 2020-04-10 |
| 1932730306 | Kerstie Kay Sims | Registered Nurse | 3950 Austell Rd, Austell, GA 30106-1121 | 2020-02-03 |
| 1386288280 | Karen L Taylor | Pharmacist | 3950 Austell Rd, Austell, GA 30106-1121 | 2019-11-04 |
| 1619510740 | Taurus Rafeal Womble | Nurse Practitioner | 3950 Austell Rd, Austell, GA 30106-1121 | 2019-10-22 |
| 1699325951 | Whitney Stafford | Nurse Anesthetist, Certified Registered | 3950 Austell Rd, Austell, GA 30106-1121 | 2019-09-18 |
| 1174177752 | Amanda Mathews Vicznesky | Physician Assistant | 3950 Austell Rd, Austell, GA 30106-1121 | 2019-07-31 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073126231 | Courtney Lashune Dorsett | Nurse Practitioner | 1005 Cureton Drive, Austell, Austell, GA 30106 | 2020-08-27 |
| 1184240491 | Brian H Eves | Dietitian, Registered | 3972 Brantley Drive, Austell, GA 30106 | 2020-06-23 |
| 1669014486 | Jesse Mccoy | Registered Nurse | 3950 Austell Rd., Austell, GA 30106 | 2019-10-14 |
| 1427522820 | Envision Optics LLC | Optometrist | 1680 E West Connector, Austell, GA 30106 | 2019-01-18 |
| 1972042380 | Thomas Dental Group | Clinic/Center | 1133 East West Connector, Suite 120, Austell, GA 30106 | 2017-02-17 |
| 1245779792 | Colton Dental Group | Clinic/Center | 2495 East-west Connector, Ste 60, Austell, GA 30106 | 2017-02-16 |
| 1144691684 | Georgia Dental Professionals, PC | Dentist | 780 East West Connector Sw, Suite 108, Austell, GA 30106 | 2015-10-09 |
| 1285013714 | Ikeade Bello Alamu | Nurse Practitioner | 2870 Betula Drive, Austell, GA 30106 | 2015-05-29 |
| 1376922211 | Jessica Williams | Obstetrics & Gynecology | 1700 Hospital South Dr Ste 500, Austell, GA 30106 | 2015-05-26 |
| 1558799593 | Tonya Renee Baldwin | Speech-Language Pathologist | 4229 Brass Trl., Austell, GA 30106 | 2013-10-30 |
| Find all providers in zip 30106 | ||||
| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073126231 | Courtney Lashune Dorsett | Nurse Practitioner | 1005 Cureton Drive, Austell, Austell, GA 30106 | 2020-08-27 |
| 1932601143 | Joy Chidinma Ezuma | Nurse Practitioner | 2615 E West Connector Ste 106, Austell, GA 30106-6848 | 2018-03-03 |
| 1730448564 | Marilyn Elaine Whitening | Nurse Practitioner | 1707 Blair Bridge Rd, Austell, GA 30168-5537 | 2012-05-14 |
| 1801189972 | Cheri Staples Staples Matthews | Nurse Practitioner | 3825 Medical Park Dr, Suite 301, Austell, GA 30106 | 2011-05-24 |
| 1962001834 | Camille Patrice Mckenzie-brown | Nurse Practitioner | 3950 Austell Rd, Austell, GA 30106-1121 | 2020-10-22 |
| 1588223697 | Dana Marie Myers | Nurse Practitioner | 3950 Austell Rd, Austell, GA 30106-1121 | 2019-06-12 |
| 1497310460 | Eric Stephen Markham | Nurse Practitioner | 3950 Austell Rd, Austell, GA 30106-1121 | 2019-05-06 |
| 1245793025 | Jazmin Raadsen | Nurse Practitioner | 3950 Austell Rd, Austell, GA 30106-1121 | 2019-04-09 |
| 1932661600 | Kiki Toyaa Reid | Nurse Practitioner | 3950 Austell Rd, Austell, GA 30106-1121 | 2019-04-02 |
| 1952877748 | Natani K Butler | Nurse Practitioner | 3950 Austell Rd, Austell, GA 30106-1121 | 2018-10-18 |
| Find all providers in AUSTELL | ||||
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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.