ANGEL LEGARE (NPI# 1649770678) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649770678 |
| Entity Type | Individual |
| Full Name | ANGEL LEGARE |
| Credential | PA-C |
| Practice Address |
404 Town Park Blvd Ste 101 Evans GA 30809 |
| Mailing Address |
404 Town Park Blvd Ste 101 Evans GA 30809-3491 |
| Practice Telephone | 7063645065 |
| Practice Fax Number | 7069227247 |
| Mailing Telephone | 7063645065 |
| Enumeration Date | 2018-02-16 |
| Last Update Date | 2019-09-05 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1120 15th St, Augusta, GA 309120004 | 7067214951 | |
| 404 Town Park Blvd Ste 101, Evans, GA 30809 | 7063645065 | 7069227247 |
| Street Address |
404 TOWN PARK BLVD STE 101 |
| City | EVANS |
| State | GA |
| Zip Code | 30809 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326674060 | Dominion Behavioral Health Services LLC | Psychiatric Unit | 817 Prairie Lane, Evans, GEORGIA 30809 | 2020-03-13 |
| 1710478102 | Georgia Dental Professionals, PC | Dentist | 5131 Washington Rd, Evans, GA 30809 | 2018-05-22 |
| 1952829541 | Felicia Evette Rhodes | Home Health Aide | 715 Jones Creek, Evans, GA 30809 | 2017-09-02 |
| 1659733582 | Patricia J. Stewart Lpc, LLC | Counselor | 465 N. Belair Rd. Ste 2d, Evans, GA 30809 | 2016-03-21 |
| 1114306727 | John Mccaskey | Family Medicine | 465 N Belair Rd Ste 1b, Evans, GA 30809 | 2015-05-28 |
| 1053702878 | Jennifer Wahl | Assistant Behavior Analyst | 1135 Waltons Pass, Evans, GA 30809 | 2015-02-16 |
| 1609298777 | Custom Pharmacy, Inc | Pharmacy | 1202 Town Park Lane, Suite 200, Evans, GA 30809 | 2014-01-09 |
| 1457797938 | Perfect Health Always On Call, LLC | Non-Pharmacy Dispensing Site | 4244 Washington Rd, Evans, GA 30809 | 2013-05-11 |
| 1417207119 | Tommy Battle | Respiratory Therapist, Registered | 101 Pond View, Evans, GA 30809 | 2012-09-11 |
| 1225387053 | Dennis Lester Trado | Pharmacist | 1415 Ashwood Dr, Evans, GA 30809 | 2012-09-07 |
| Find all providers in zip 30809 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740724996 | Elizabeth O'hara Richardson | Physician Assistant | 447 N Belair Rd Ste 101, Evans, GA 30809-3091 | 2016-12-07 |
| 1831646041 | Stephen Robert Dominey | Physician Assistant | 4301 University Pkwy, Evans, GA 30809-3089 | 2016-09-06 |
| 1982056719 | Erin Manak | Physician Assistant | 2930 11th Ave, Evans, CO 80620-1011 | 2016-07-05 |
| 1104254184 | Jessica Fields | Physician Assistant | 902 Ponder Place Ct, Suite 3, Evans, GA 30809-3184 | 2013-10-29 |
| 1962784785 | Kenneth Ray Johnson | Physician Assistant | 1203 Town Park Ln, Evans, GA 30809 | 2011-09-19 |
| 1952540817 | Lonna Dee Bloom | Physician Assistant | 2930 11th Ave, Evans, CO 80620-1011 | 2009-02-16 |
| 1144213562 | Delores Schwartz | Physician Assistant | 465 N Belair Rd, Ste 1b, Evans, GA 30809-3188 | 2005-08-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245838374 | Erica Elizabeth West | Physician Assistant | 1155 Mount Vernon Hwy Ste 101, Atlanta, GA 30338-5439 | 2020-10-12 |
| 1801402888 | Meredith Gaines | Physician Assistant | 603 W 1st St Unit 1, Rome, GA 30161-3067 | 2020-09-16 |
| 1770108805 | Kelsey Lynne Greeff | Physician Assistant | 3400 Old Milton Pkwy Ste C, Alpharetta, GA 30005-3707 | 2020-06-15 |
| 1518596733 | Rebecca Faye Tsyrlin | Physician Assistant | 2655 Dallas Hwy Sw Ste 340, Marietta, GA 30064-7518 | 2020-04-08 |
| 1487291878 | Ashley Cohen | Physician Assistant | 250 E Ponce De Leon Ave Ste 800, Decatur, GA 30030-3438 | 2019-12-04 |
| 1932757606 | Andrea J Holley | Physician Assistant | 1629 Austin Meadows Dr, Decatur, GA 30032-3888 | 2019-08-27 |
| 1265089759 | Alexis Chester Jones | Physician Assistant | 3000 Old Alabama Rd # 128, Johns Creek, GA 30022-5860 | 2019-08-20 |
| 1841851680 | Lauren Price Fogarty | Physician Assistant | 5445 Meridian Marks Rd Ste 430, Atlanta, GA 30342-4755 | 2019-06-24 |
| 1386208262 | Jessica A Drews | Physician Assistant | 2342 Cortez Way Ne, Brookhaven, GA 30319-3914 | 2019-04-26 |
| 1174187421 | Krisna Patel | Physician Assistant | 1805 Honey Creek Cmns Se Ste B, Conyers, GA 30013-5829 | 2019-04-23 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on ANGEL LEGARE.
| 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.