BEAU PHILIP GEDRICK (NPI# 1679899215) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679899215 |
| Entity Type | Individual |
| Full Name | BEAU PHILIP GEDRICK |
| Credential | D.O. |
| Practice Address |
1102 15th St Augusta GA 30912-0004 |
| Mailing Address |
1499 Walton Way Ste. 1400 Augusta GA 30901-2602 |
| Practice Telephone | 7067246100 |
| Mailing Telephone | 7067246100 |
| Enumeration Date | 2010-04-07 |
| Last Update Date | 2017-05-03 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207P00000X | Emergency Medicine | 075463 | GA | Allopathic & Osteopathic Physicians |
| Y | 207PS0010X |
Emergency Medicine Specialization: Sports Medicine |
075463 | GA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 003173115B | 05 |
| Street Address |
1102 15TH ST |
| City | AUGUSTA |
| State | GA |
| Zip Code | 30912-0004 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548885940 | Hannah Gullickson Folsom | Family Medicine | 1459 Laney Walker Blvd Ae 3042, Augusta, GA 30912 | 2020-06-11 |
| 1487278909 | Robert Kennedy | Internal Medicine | Augusta University Internal Medicine Residency Program, 1120 15th Street, Bi 5070, Augusta, GA 30912 | 2020-06-01 |
| 1952968737 | Kayla M. Lasota | Pediatrics | 11230 115th St Ae3042, Augusta, GA 30912 | 2019-05-28 |
| 1003379280 | Kayla Cox | Internal Medicine | 1120 15th St Bi5070, Augusta, GA 30912 | 2019-04-13 |
| 1619435740 | Justin Ray Mackert | Student in an Organized Health Care Education/Training Program | Augusta University, 1120 15th Street, Gc 5110, Augusta, GA 30912 | 2019-03-07 |
| 1417444167 | Victor Celis | Dentist | John Wesley Gilbert Dr, Augusta, GA 30912 | 2018-04-18 |
| 1487157921 | Julie Ann Matsen | Student in an Organized Health Care Education/Training Program | 997 St. Sebastian Way, Eg-2021-10, Augusta Univ., Dept. of Psychiatry & Health Behavior, Augusta, GA 30912 | 2018-03-12 |
| 1497287031 | Luke Yuung-jier Chang | Ophthalmology | 1120 15th St # Ba2720, Augusta, GA 30912 | 2017-04-02 |
| 1821537622 | Lashawn Kay Boone | Nurse Practitioner | 1445 Harper St, Augusta, GA 30912 | 2017-02-14 |
| 1134675564 | Arnab Saha | Internal Medicine | 1120 15 Th St., Augusta, GA 30912 | 2016-08-26 |
| Find all providers in zip 30912 | ||||
| Taxonomy Code | 207PS0010X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| Specialization | Sports Medicine |
| An emergency physician with special knowledge in sports medicine is responsible for continuous care in the field of sports medicine, not only for the enhancement of health and fitness, but also for the prevention and management of injury and illness. A sports medicine physician has knowledge and experience in the promotion of wellness and the role of exercise in promoting a healthy lifestyle. Knowledge of exercise physiology, biomechanics, nutrition, psychology, physical rehabilitation and epidemiology is essential to the practice of sports medicine. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Emergency Medicine, 2007. http://www.abem.org/public/. American Osteopathic Board of Emergency Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Emergency Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093286411 | Shelley Jakiel | Emergency Medicine | 2083 Skylar Leigh Dr, Buford, GA 30518-2484 | 2018-12-11 |
| 1902437288 | Zaida Hall | Emergency Medicine | 231 W Hancock St, Milledgeville, GA 31061-3371 | 2020-01-27 |
| 1427605005 | Jubilee Grace Herrs | Emergency Medicine | 100 Smith St, Athens, GA 30602-1505 | 2019-08-20 |
| 1861976367 | Indya Denise Brown | Emergency Medicine | 1501 Mercer University Dr, Macon, GA 31207-1515 | 2018-09-20 |
| 1629381876 | Raven Kae Belmonte | Emergency Medicine | 4484 Peachtree Rd Ne, Atlanta, GA 30319 | 2010-07-16 |
| 1104824069 | Otis A Plunk | Emergency Medicine | 1140 Hammond Dr Ne, Building I, Ste 9100, Atlanta, GA 30328-5338 | 2005-07-13 |
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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.