DR. GARY DERUSSO II (NPI# 1548657398) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1548657398 |
| Entity Type | Individual |
| Full Name | DR. GARY DERUSSO II |
| Credential | MD |
| Practice Address |
3950 Austell Rd Austell GA 30106 |
| Mailing Address |
3950 Austell Rd Austell GA 30106-1121 |
| Practice Telephone | 7707323585 |
| Practice Fax Number | 7707323589 |
| Mailing Telephone | 7707323585 |
| Mailing Fax Number | 7707323589 |
| Enumeration Date | 2015-04-20 |
| Last Update Date | 2019-09-26 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RH0002X |
Internal Medicine Specialization: Hospice and Palliative Medicine |
83581 | GA | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| Dept of Medicine Hsc Level 16, Stony Brook Hospital, Stony Brook, NY 117940001 | 6314442058 | 6314442493 |
| 1250 E Marshall St, Richmond, VA 23298 | 8048285094 |
| Street Address |
3950 AUSTELL RD |
| City | AUSTELL |
| State | GA |
| Zip Code | 30106 |
| 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 | 207RH0002X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Hospice and Palliative Medicine |
| An internal medicine physician with special knowledge and skills to prevent and relieve the suffering experienced by patients with life-limiting illnesses. This specialist works with an interdisciplinary hospice or palliative care team to maximize quality of life while addressing physical, psychological, social and spiritual needs of both patient and family throughout the course of the disease, through the dying process, and beyond for the family. This specialist has expertise in the assessment of patients with advanced disease; the relief of distressing symptoms; the coordination of interdisciplinary patient and family-centered care in diverse venues; the use of specialized care systems including hospice; the management of the imminently dying patient; and legal and ethical decision making in end-of-life care. |
| Notes: Source: American Academy of Hospice and Palliative Medicine, www.aahpm.org [1/1/2007: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063680049 | Wellstar Palliative Medicine, LLC | Internal Medicine | 4040 Hospital West Dr, Austell, GA 30106-8117 | 2008-02-13 |
| 1396966016 | Anjali Parmar Grandhige | Internal Medicine | 4040 Hospital West Dr, Austell, GA 30106 | 2007-05-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689221749 | Family First Palliative Care LLC | Internal Medicine | 2299 Saint Kennedy Lane, Buford, GA 30518 | 2019-08-23 |
| 1396205696 | Hospice Advantage, LLC | Internal Medicine | 107 Southern Blvd Ste 203, Savannah, GA 31405-7435 | 2019-03-22 |
| 1053877993 | Compassus Op of Georgia II LLC | Internal Medicine | 1000 Northside Xing, Macon, GA 31210-2278 | 2019-02-15 |
| 1285190116 | Hospice Advantage, LLC. | Internal Medicine | 2470 Daniels Bridge Rd Ste 171, Athens, GA 30606-6188 | 2019-02-15 |
| 1215245634 | Ginpen, LLC | Internal Medicine | 238 Old Norton Rd, Fayetteville, GA 30215-4921 | 2010-09-20 |
| 1518525112 | Veneranda Ngulefac | Internal Medicine | 1395 S Marietta Pkwy Se Ste 216, Marietta, GA 30067-7832 | 2019-05-30 |
| 1366902058 | Pruitthealth Hospice, Inc. | Internal Medicine | 6060 Lakeside Commons Dr, Macon, GA 31210-5778 | 2019-03-20 |
| 1932672300 | St. Mary's Medical Group, Inc. | Internal Medicine | 1021 Jamestown Blvd Ste 215, Watkinsville, GA 30677-4176 | 2019-01-08 |
| 1235669045 | Sb Healthcare, LLC | Internal Medicine | 2000 Riverside Pkwy Ste 107, Lawrenceville, GA 30043-5926 | 2017-06-14 |
| 1568999779 | Umg Palliative Care LLC | Internal Medicine | 1350 Walton Way, Augusta, GA 30901-2612 | 2017-05-18 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on DR. GARY DERUSSO II.
| 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.