MERCER UNIVERSITY SCHOOL OF MEDICINE (NPI# 1659705986) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1659705986 |
| Entity Type | Organization |
| Organization Name | MERCER UNIVERSITY SCHOOL OF MEDICINE |
| Practice Address |
1400 Coleman Ave Macon GA 31207-0001 |
| Practice Telephone | 4783012700 |
| Enumeration Date | 2013-08-22 |
| Last Update Date | 2013-08-22 |
| Authorized Official Name | ALICE HOUSE (SR. ASSOCIATE DEAN FOR ADMISSIONS) |
| Authorized Official Telephone | 4783012531 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | GA | Student, Health Care |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619301991 | Mercer University School of Medicine | Student in an Organized Health Care Education/Training Program | 1550 College St, Macon, GA 31207-1500 | 2013-08-22 |
| 1093055766 | Mercer University School of Medicine | Student in an Organized Health Care Education/Training Program | 1550 College St, Macon, GA 31204 | 2013-02-18 |
| Street Address |
1400 COLEMAN AVE |
| City | MACON |
| State | GA |
| Zip Code | 31207-0001 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285747642 | Kristin Elizabeth Bourque | Specialist/Technologist | 1400 Coleman Ave, Mercer University Athletic Department, Macon, GA 31207-0001 | 2006-08-17 |
| 1619400348 | Devon Tobey | Student in an Organized Health Care Education/Training Program | 1400 Coleman Ave, Macon, GA 31207-1100 | 2017-04-10 |
| 1205245016 | Tipton Dovey Sholes | Student in an Organized Health Care Education/Training Program | 1400 Coleman Ave, Macon, GA 31207-0001 | 2014-08-05 |
| 1306270210 | Michael Lowery | Student in an Organized Health Care Education/Training Program | 1400 Coleman Ave, Macon, GA 31207-0001 | 2013-08-27 |
| 1619301884 | Samuel Devictor | Student in an Organized Health Care Education/Training Program | 1400 Coleman Ave, Macon, GA 31207-0001 | 2013-08-23 |
| 1770917155 | Annalee Joy Wittmeyer | Student in an Organized Health Care Education/Training Program | 1400 Coleman Ave, Macon, GA 31207-0001 | 2013-08-21 |
| 1861825499 | Matthew Warren | Student in an Organized Health Care Education/Training Program | 1400 Coleman Ave, Macon, GA 31207-0001 | 2013-08-19 |
| 1033558630 | Ayesha Tabassom | Student in an Organized Health Care Education/Training Program | 1400 Coleman Ave, Macon, GA 31207-0001 | 2013-06-18 |
| 1962750323 | Justin Mcivor Law | Family Medicine | 1400 Coleman Ave, Macon, GA 31207-0001 | 2012-08-16 |
| 1962780999 | Eric R Carter | Specialist/Technologist | 1400 Coleman Ave, Macon, GA 31207-0001 | 2011-07-25 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770004715 | Renee Boudreaux | Podiatrist | 1501 Mercer University Dr, Macon, GA 31207 | 2017-06-29 |
| 1316296627 | Jonathan Gustav Bulla | Student in an Organized Health Care Education/Training Program | 1550 College Street, Macon, GA 31207 | 2012-08-31 |
| 1366723751 | Abigail Lewis | Family Medicine | 1550 College St, Macon, GA 31207 | 2011-08-30 |
| 1265596589 | Elizabeth Jean Hudson-weires | Registered Nurse | 1550 College Street, Macon, GA 31207 | 2006-12-21 |
| 1316593262 | Nicole Theresia Mette | Student in an Organized Health Care Education/Training Program | 1550 College St Mercer University School of Medicine, Macon, GA 31207-0001 | 2019-08-16 |
| 1558921973 | Anna Nielsen Walker | Pathology | Mercer University School of Medicine Dept of Pathology, Macon, GA 31207-0001 | 2019-06-18 |
| 1770057788 | Brian Daniel Wright | Student in an Organized Health Care Education/Training Program | 1550 College Steeet, Macon, GA 31207-0001 | 2019-01-14 |
| 1710481049 | Sarah Nicole Telliard | Student in an Organized Health Care Education/Training Program | Mercer University School of Medicine 1550 College St, Macon, GA 31207-0001 | 2018-03-21 |
| 1174925416 | William Holcomb | Specialist/Technologist | 1501 Mercer University Drive Mercer University, Macon, GA 31207-0001 | 2014-09-18 |
| 1760665913 | Daniel John Gibbs | Specialist/Technologist | University Athletics, 1400 Coleman Ave, Macon, GA 31207-0001 | 2007-12-11 |
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| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760005664 | Jackson Rodgers | Student in an Organized Health Care Education/Training Program | 5a Whispering Pines Ct, Macon, IL 62544-7218 | 2020-05-26 |
| 1548882780 | Lauren Elizabeth Lewis | Student in an Organized Health Care Education/Training Program | 790 1st St, Macon, GA 31201-6874 | 2020-05-11 |
| 1639708654 | Nehal Ninad | Student in an Organized Health Care Education/Training Program | 777 Hemlock Street Ln, Macon, GA 31201-2168 | 2020-04-02 |
| 1346878279 | Albarra Younis | Student in an Organized Health Care Education/Training Program | 6445 Stapleton Rd, Macon, GA 31216-5234 | 2020-03-27 |
| 1396372496 | Joseph Martin Roberts | Student in an Organized Health Care Education/Training Program | 777 Hemlock Street Ln # 42, Macon, GA 31201-2168 | 2020-03-26 |
| 1336775204 | Christopher Robin Denham | Student in an Organized Health Care Education/Training Program | 380 Hospital Dr Bldg A, Macon, GA 31217-8001 | 2020-03-23 |
| 1144852856 | Rachel Kathryn Albrecht | Student in an Organized Health Care Education/Training Program | 1500 College St, Macon, GA 31207-1500 | 2020-02-11 |
| 1710519616 | Elisha Scott | Student in an Organized Health Care Education/Training Program | 1345 Hardeman Ave Apt 415a, Macon, GA 31201-4403 | 2020-02-08 |
| 1871125179 | Aaron Daniel Brown | Student in an Organized Health Care Education/Training Program | 804 Locust St, Macon, MO 63552-1846 | 2020-02-05 |
| 1316593262 | Nicole Theresia Mette | Student in an Organized Health Care Education/Training Program | 1550 College St Mercer University School of Medicine, Macon, GA 31207-0001 | 2019-08-16 |
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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.