CAMERON MEDINA (NPI# 1548786585) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1548786585 |
| Entity Type | Individual |
| Full Name | CAMERON MEDINA |
| Credential | PA-C |
| Practice Address |
705 Dixie St Carrollton GA 30117-3818 |
| Mailing Address |
103 Hidden Lake Dr Bremen GA 30110-7910 |
| Practice Telephone | 7708369666 |
| Mailing Telephone | 7708421330 |
| Enumeration Date | 2017-08-22 |
| Last Update Date | 2017-08-22 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 8408 | GA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
705 DIXIE ST |
| City | CARROLLTON |
| State | GA |
| Zip Code | 30117-3818 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407848799 | Lawrence Brett Carter | Pharmacist | 705 Dixie St, Carrollton, GA 30117-3818 | 2005-08-22 |
| 1760007322 | Crystal Renee Grayson | Nurse Anesthetist, Certified Registered | 705 Dixie St, Carrollton, GA 30117-3818 | 2020-06-10 |
| 1962025361 | Amanda Hasty Mcentyre | Dietitian, Registered | 705 Dixie St, Carrollton, GA 30117-3818 | 2020-05-20 |
| 1265055669 | Purdy Jackson | Dietitian, Registered | 705 Dixie St, Carrollton, GA 30117-3818 | 2020-05-20 |
| 1528681921 | Amanda Phillips Kranz | Dietitian, Registered | 705 Dixie St, Carrollton, GA 30117-3818 | 2020-05-20 |
| 1699396630 | Katherine Victoria White | Nurse Practitioner | 705 Dixie St, Carrollton, GA 30117-3818 | 2020-04-30 |
| 1144866047 | Jennifer Tiffany Jiles | Nurse Practitioner | 705 Dixie St, Carrollton, GA 30117-3818 | 2019-11-26 |
| 1750934733 | Tiffany Landry | Health Educator | 705 Dixie St, Carrollton, GA 30117-3818 | 2019-07-19 |
| 1104479195 | Kim Rowell | Health Educator | 705 Dixie St, Carrollton, GA 30117-3818 | 2019-07-19 |
| 1104478916 | Brandon Gabe Graves | Nurse Anesthetist, Certified Registered | 705 Dixie St, Carrollton, GA 30117-3818 | 2019-07-11 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679199392 | Southern Rad Onc LLC | Radiology | 809 South Park Street, Carrollton, GA 30117 | 2020-06-18 |
| 1093361404 | Eyedeal Eyecare LLC | Optometrist | 1735 S Us 27, Carrollton, GA 30117 | 2019-08-12 |
| 1710412473 | Janis James | Optometrist | 1735 S, Us-27, Walmart Vision Center, Carrollton, GA 30117 | 2017-05-01 |
| 1568881951 | Omar Hajmurad | Anesthesiology | 812 S Park St Ste 5, Carrollton, GA 30117 | 2014-04-14 |
| 1134550353 | Goodbodys Minor Med Express Care | Nurse Practitioner | 1670 South Park St., Carrollton, GA 30117 | 2013-12-13 |
| 1306187570 | Myriam C Vela-ortiz | Internal Medicine | 157 Clinic Ave Ste 203, Carrollton, GA 30117 | 2013-03-12 |
| 1891030201 | Air Evac Ems, Inc. | Ambulance | 827 Old Bremen Rd, Carrollton, GA 30117 | 2012-12-11 |
| 1952682486 | Angelic Wings Transport, Inc. | Non-emergency Medical Transport (VAN) | 362 B Columbia Drive, Carrollton, GA 30117 | 2011-08-29 |
| 1073819256 | Atlanta Prosthetics & Orthotics, Inc. | Durable Medical Equipment & Medical Supplies | 812 South Park Street, Suite 2, Carrollton, GA 30117 | 2011-02-04 |
| 1255640348 | Amy Gilbert | Counselor | 515 Tanner St, Carrollton, GA 30117 | 2010-10-06 |
| Find all providers in zip 30117 | ||||
| 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 |
|---|---|---|---|---|
| 1295333532 | Victoria Jane Campbell | Physician Assistant | 4412 Young Dr, Carrollton, TX 75010-1144 | 2020-10-09 |
| 1073129276 | Versoal, Pllc | Physician Assistant | 2459 E Hebron Pkwy Ste 100, Carrollton, TX 75010-4477 | 2020-09-22 |
| 1679099477 | Alyssa Musa Ali | Physician Assistant | 1301 Oneida Dr, Carrollton, TX 75010-2303 | 2017-08-14 |
| 1164887899 | Jashica Desai | Physician Assistant | 4300 N Josey Ln Ste 110, Carrollton, TX 75010-4681 | 2015-12-22 |
| 1538473343 | Christie Marie Redrow | Physician Assistant | 1237 Stillwater Trl, Carrollton, TX 75007-6230 | 2010-08-04 |
| 1518290378 | Kimberly A Quinter | Physician Assistant | 16160 Quail Crescent Ln, Carrollton, VA 23314-2251 | 2009-09-11 |
| 1861623951 | Asma Ashiqali Bhaidani | Physician Assistant | 4125 Fairway Dr Ste 190, Carrollton, TX 75010 | 2009-08-06 |
| 1942328984 | Autumn Deese Davis | Physician Assistant | 401 Dixie St, Carrollton, GA 30117-3921 | 2007-03-27 |
| 1306984679 | Richard C Schutt | Physician Assistant | 4780 N Josey Lane, Carrollton, TX 75010 | 2007-02-01 |
| 1437222783 | Gary Steven Marcum | Physician Assistant | 1702 E Belt Line Rd, Carrollton, TX 75006-6375 | 2006-11-16 |
| Find all providers in CARROLLTON | ||||
| City | CARROLLTON |
| Zip Code | 30117 |
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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.