BIBOMBA DAVENPORT (NPI# 1679901995) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679901995 |
| Entity Type | Individual |
| Full Name | BIBOMBA DAVENPORT |
| Practice Address |
2550 Cobb Pkwy Se 204 Smyrna GA 30080-3020 |
| Mailing Address |
4100 Brightmore Dr Austell GA 30106-4639 |
| Practice Telephone | 4045102604 |
| Mailing Telephone | 4045102604 |
| Enumeration Date | 2013-10-23 |
| Last Update Date | 2013-10-23 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1744P3200X |
Specialist Specialization: Prosthetics Case Management |
1744P3200X | GA | Other Service Providers |
| Street Address |
2550 COBB PKWY SE 204 |
| City | SMYRNA |
| State | GA |
| Zip Code | 30080-3020 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013426386 | In Time of Need, Inc. | Meals | 2550 Cobb Pkwy Se, Smyrna, GA 30080-3020 | 2017-09-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881205169 | Suny Varughese | Nurse Practitioner | Minute Clinic, 2994 Atlanta Rd, Se, Smyrna, GA 30080 | 2020-08-11 |
| 1891287645 | Provident Group - Creekside Properties LLC | Alzheimer Center (Dementia Center) | 4838 South Cobb Drive, Smyrna, GA 30080 | 2018-06-06 |
| 1710490743 | Alina Rim | Registered Nurse | 4532 Chelton Ct Se, Smyrna, GA 30080 | 2017-11-13 |
| 1932626488 | Richard Kyle Davis | Pharmacist | 2955 Atlanta Rd Se, Smyrna, GA 30080 | 2017-08-25 |
| 1982071163 | Amelia Rafaela Turrubiates-huacuja | Counselor | 1246-c Concord Rd, Suite 101, Smyrna, GA 30080 | 2015-08-24 |
| 1275919755 | Anne Waldner Rohling | Physical Therapist | 1155 Concord Rd Se Ste 210, Smyrna, GA 30080 | 2015-08-06 |
| 1790167856 | Kay Yetunde Johnson | Nurse Practitioner | 3001 Lusk Dr, Smyrna, GA 30080 | 2015-06-25 |
| 1689055436 | Anew You Couneling, LLC | Community/Behavioral Health | 3188 Atlanta Rd, Smyrna, GA 30080 | 2015-06-17 |
| 1457766370 | Trondi Jerry | Counselor | 3381 Atlanta Rd Se, Smyrna, GA 30080 | 2014-06-30 |
| 1093081903 | Ashish Kapila | Podiatrist | Wellstar Podiatry, 4441 Atlanta Rd Se Suite 215, Smyrna, GA 30080 | 2012-03-25 |
| Find all providers in zip 30080 | ||||
| Taxonomy Code | 1744P3200X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| Specialization | Prosthetics Case Management |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124555115 | Angel Johnson | Specialist | 2400 Herodian Way Se Ste 375, Smyrna, GA 30080-8581 | 2017-05-22 |
| 1366884116 | Dynasty Elegance | Specialist | 2365 Spring Rd Se, Smyrna, GA 30080-2632 | 2013-07-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225638448 | Shariyfa Ferron | Specialist | 1864 Scenic Hwy N Ste 112, Snellville, GA 30078-2549 | 2020-10-27 |
| 1851908016 | Takenya Lacole Jordan | Specialist | 2231 Dawson Rd Ste Ij, Albany, GA 31707-3227 | 2020-09-30 |
| 1437765724 | Shanea Buie | Specialist | 5977 Whitesville Rd Ste 20, Columbus, GA 31904-3618 | 2020-09-22 |
| 1114537313 | Kimberly Melissa Sampson | Specialist | 2386 Clower St Ste 102, Snellville, GA 30078-6134 | 2020-08-04 |
| 1295351302 | Marquisha General | Specialist | 1639 Lower Roswell Rd, Marietta, GA 30068-3343 | 2020-06-24 |
| 1053937805 | Angela D Zanders | Specialist | 1600 E Forsyth St, Americus, GA 31709-3856 | 2020-06-17 |
| 1770107526 | Natasha Monic Douglas | Specialist | 1630 Scenic Hwy N, Snellville, GA 30078-5647 | 2020-06-07 |
| 1518595479 | Jacque Monae LLC | Specialist | 4955 Sugarloaf Pkwy Ste 104, Lawrenceville, GA 30044-8838 | 2020-03-27 |
| 1518592716 | Naquiesha Peterson | Specialist | 3510 Ponderosa Ln, Powder Springs, GA 30127-2074 | 2020-03-08 |
| 1295368900 | Doris Huff Hardeman | Specialist | 75 Rolling Ridge Dr, Covington, GA 30016-1823 | 2020-02-20 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on BIBOMBA DAVENPORT.
| 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.