MS. MARY DIFONZO (NPI# 1649585415) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649585415 |
| Entity Type | Individual |
| Full Name | MS. MARY DIFONZO |
| Credential | MARY DIFONZO PA-C |
| Practice Address |
30 Chateau Dr Se Rome GA 30161-7201 |
| Mailing Address |
902 Hilton Ave Baltimore MD 21228-5874 |
| Practice Telephone | 7062913753 |
| Mailing Telephone | 4107478382 |
| Enumeration Date | 2010-08-17 |
| Last Update Date | 2010-08-17 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | C00001729 | MD | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
30 CHATEAU DR SE |
| City | ROME |
| State | GA |
| Zip Code | 30161-7201 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134103450 | Mildred Joann Santorufo | Family Medicine | 30 Chateau Dr Se, Rome, GA 30161-7201 | 2005-11-30 |
| 1275940355 | Atlanta Vamc | Clinic/Center | 30 Chateau Dr Se, Rome, GA 30161-7201 | 2014-07-21 |
| 1508179441 | James Jonathan Mitchell | Pharmacist | 30 Chateau Dr Se, Rome, GA 30161-7201 | 2010-07-20 |
| 1285898965 | Dolores Ann Wells | Licensed Practical Nurse | 30 Chateau Dr Se, Rome, GA 30161-7201 | 2008-07-11 |
| 1124139902 | Annette Louise Toler | Internal Medicine | 30 Chateau Dr Se, Rome, GA 30161-7201 | 2006-08-31 |
| 1316962293 | Tammy Sumrall Lovette | Family Medicine | 30 Chateau Dr Se, Rome, GA 30161-7201 | 2006-07-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265069256 | Three Rivers Housing and Development Corporation | Chore Provider | 326 W. 9th St, Rome, GA 30161 | 2020-03-27 |
| 1144865957 | Eric Alan Fuller | Audiologist-Hearing Aid Fitter | 700 East 2nd Street, Suite C, Rome, GA 30161 | 2019-11-15 |
| 1003394883 | Cindy V Shelton | Health Educator | 204 E 1st Ave, Rome, GA 30161 | 2018-08-02 |
| 1083153597 | Julie Oglesby Allen | Counselor | 1 S Broad St Sw Ste 5, Rome, GA 30161 | 2017-02-16 |
| 1902299530 | Michael Thomas Phillips | Pharmacist | 2005 Maple Street, Rome, GA 30161 | 2015-03-06 |
| 1407259112 | Angela Smith | Community/Behavioral Health | 109 John Maddox Suite 200, Rome, GA 30161 | 2014-10-08 |
| 1215344379 | Nancy Patel | Pharmacist | 1421 North Broad St, Rome, GA 30161 | 2014-07-21 |
| 1821336629 | Wendy Pence | Nurse Practitioner | 3001 Turner Mccall Blvd, Rome, GA 30161 | 2013-01-29 |
| 1558526202 | Marilyn Teresa Ringstaff | Registered Nurse | 1513 Dean St., Rome, GA 30161 | 2008-07-22 |
| 1134310147 | Reneka L Dobbs-jackson | Family Medicine | 420 E 2nd Ave Ste 103, Rome, GA 30161 | 2007-08-05 |
| Find all providers in zip 30161 | ||||
| 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 |
|---|---|---|---|---|
| 1518587781 | Chandler Holcombe | Physician Assistant | 100 Three Rivers Dr Ne, Rome, GA 30161-4999 | 2020-04-17 |
| 1609400886 | Morgan Elise Benson Baker | Physician Assistant | 123 Three Rivers Dr Ne, Rome, GA 30161-2300 | 2020-02-26 |
| 1548805401 | Mallory Elizabeth Osborne | Physician Assistant | 330 Turner Mccall Blvd Sw, Rome, GA 30165-5630 | 2019-11-14 |
| 1710522933 | William Edward Johnson | Physician Assistant | 550 Redmond Rd Nw, Rome, GA 30165-1416 | 2019-11-12 |
| 1225670532 | Caleb Elisha Etheridge | Physician Assistant | 1825 Martha Berry Blvd Nw, Rome, GA 30165-1625 | 2019-10-09 |
| 1659934321 | Tara Simonson | Physician Assistant | 310 W 10th St Ne, Rome, GA 30165-2639 | 2019-04-18 |
| 1255805180 | Amanda Lynn Preteroti | Physician Assistant | 504 Redmond Rd Nw, Rome, GA 30165-1416 | 2019-01-14 |
| 1528535036 | Jaskirt Kaur Chahal | Physician Assistant | 1617 N James St, Rome, NY 13440-2852 | 2018-11-01 |
| 1205311131 | Austin James Malcom | Physician Assistant | 550 Redmond Rd Nw, Rome, GA 30165-1416 | 2018-09-26 |
| 1215439286 | Swaraj Suhas Hublikar | Physician Assistant | 1825 Martha Berry Blvd Nw, Rome, GA 30165-1625 | 2018-03-06 |
| Find all providers in ROME | ||||
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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.