MR. KENNETH B. ROLAND JR. (NPI# 1699828152) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1699828152 |
| Entity Type | Individual |
| Full Name | MR. KENNETH B. ROLAND JR. |
| Credential | PA-C |
| Practice Address |
300 W. Hospital Road Eisenhower Army Medical Center Fort Gordon GA 30905-2720 |
| Practice Telephone | 7067874697 |
| Practice Fax Number | 7067876735 |
| Mailing Telephone | 7067874697 |
| Mailing Fax Number | 7067876735 |
| Enumeration Date | 2007-01-19 |
| Last Update Date | 2013-10-03 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 688 | SC | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033225123 | Kenneth Duane Roland | Dentist | 174 South Fm 356, Onalaska, TX 77360-1419 | 2006-08-22 |
| Street Address |
300 W. HOSPITAL ROAD EISENHOWER ARMY MEDICAL CENTER |
| City | FORT GORDON |
| State | GA |
| Zip Code | 30905-2720 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164672390 | Trinita Denise Hall | Physical Therapy Assistant | 300 W. Hospital Road, Fort Gordon, GA 30905-5650 | 2008-09-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417508995 | Priscilla Denise Brown | Prosthetic/Orthotic Supplier | 38200 3rd Ave, Fort Gordon, GA 30905 | 2019-09-25 |
| 1740754308 | Patricia Lynn Blevins | Nurse Practitioner | 300 E Hospital Dr, Augusta, GA 30905 | 2019-01-17 |
| 1861971335 | Isabella Anderson | Dentist | Usa Dental Activity, Hospital Dental Clinic, Bldg 38801 Academic, Ste B&c, Ft Gordon, GA 30905 | 2018-08-07 |
| 1972097426 | Cortney Wolfley | Student in an Organized Health Care Education/Training Program | Orthopaedics Ddeamc, 300 East Hospital Road, Fort Gordon, GA 30905 | 2018-06-19 |
| 1003337536 | David Jonathon Sabovich | Dentist | 38801 Academic Dr Ste B&cactivity, Suite B & C, Ft Gordon, GA 30905 | 2017-07-06 |
| 1437689411 | Marcos Aranda | Student in an Organized Health Care Education/Training Program | General Surgery, Eisenhower Army Medical Center, 300 East Hospital Road, Fort Gordon, GA 30905 | 2017-06-13 |
| 1659809846 | Brian Kevin Burke | Student in an Organized Health Care Education/Training Program | 300 East Hosptial Road, Fort Gordon, GA 30905 | 2017-06-01 |
| 1902334469 | Jacqueline Renee Mulhall | Student in an Organized Health Care Education/Training Program | Ddeamc, 300 E Hospital Rd, General Surgery, Fort Gordon, GA 30905 | 2017-05-30 |
| 1750837456 | Amanda R Bailey | Internal Medicine | 300 E. Hospital Dr., Fort Gordon, GA 30905 | 2016-09-01 |
| 1689120016 | Thomas S Moffitt | Internal Medicine | Im, Dwight D Eisenhower Army Medical Center, 300 East Hospital Road, Fort Gordon, GA 30905 | 2016-08-26 |
| Find all providers in zip 30905 | ||||
| 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 |
|---|---|---|---|---|
| 1649348178 | Susan Garman Suer | Physician Assistant | Eisenhower Army Medical Center, East Hospital Road, Fort Gordon, GA 30905 | 2006-12-01 |
| 1720156342 | Levaughn Newberry | Physician Assistant | 300 West Hospital Road, Eisenhower Army Medical Center, Attn Credentials, Fort Gordon, GA 30905-5650 | 2006-12-01 |
| 1194753525 | Sunny Maria Holden | Physician Assistant | 300 E Hospital Road, Building T-300, Eisenhower Army Med Center Orthopedic Surgery Dept, Fort Gordon, GA 30905 | 2006-06-28 |
| 1538146485 | William James Nieding | Physician Assistant | 300 East H, Dwight David Eisenhower Army Medical Center, Fort Gordon, GA 30905 | 2005-12-30 |
| 1861657447 | Eugene Dale Beverly | Physician Assistant | 300 W Hospital Rd, Connelly Health Clinic, Fort Gordon, GA 30905-5741 | 2008-07-23 |
| 1891843124 | Pamela Ann Hiener | Physician Assistant | 300 W Hospital Rd, Attn Credentials, Fort Gordon, GA 30905-5741 | 2007-01-05 |
| 1659428423 | Signe Alexis Erne | Physician Assistant | 300 W Hospital Road, Od Eisenhower Army Medical Center, Fort Gordon, GA 30905-5650 | 2007-01-04 |
| 1740341429 | John David Sanders | Physician Assistant | 300 W Hospital Rd, Fort Gordon, GA 30905-5741 | 2006-12-13 |
| 1578623799 | George Timothy Cassidy | Physician Assistant | 300 W Hospital Rd, Attn Credentials, Fort Gordon, GA 30905-5741 | 2006-12-11 |
| 1427116102 | Evelyn Ferrer | Physician Assistant | 300 Hospital Rd., Family Medicine Clinic, Fort Gordon, GA 30905-5650 | 2006-12-05 |
| Find all providers in FORT GORDON | ||||
| City | FORT GORDON |
| Zip Code | 30905 |
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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.