DR. ADEBOLA ADEKUNLE ADEOGUN (NPI# 1710939194) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710939194 |
| Entity Type | Individual |
| Full Name | DR. ADEBOLA ADEKUNLE ADEOGUN |
| Credential | MD |
| Practice Address |
400 Charter Blvd Macon GA 31210-4831 |
| Mailing Address |
1745 Phoenix Blvd Suite 100 Atlanta GA 30349-5591 |
| Practice Telephone | 7709949326 |
| Practice Fax Number | 7709944747 |
| Mailing Telephone | 7709949326 |
| Mailing Fax Number | 7709944747 |
| Enumeration Date | 2006-05-16 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207PE0004X |
Emergency Medicine Specialization: Emergency Medical Services |
042517 | GA | Allopathic & Osteopathic Physicians |
| Street Address |
400 CHARTER BLVD |
| City | MACON |
| State | GA |
| Zip Code | 31210-4831 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306814231 | John W Hightower | Anesthesiology | 400 Charter Blvd, Macon, GA 31210-4831 | 2006-03-08 |
| 1013548494 | Chelsea Hayman | Registered Nurse | 400 Charter Blvd, Macon, GA 31210-4853 | 2020-02-04 |
| 1417509001 | Kristi Tucker Jones | Nurse Practitioner | 400 Charter Blvd, Macon, GA 31210-4831 | 2019-07-12 |
| 1578035457 | Gloria Iris Smith | Nurse Practitioner | 400 Charter Blvd, Macon, GA 31210-4853 | 2018-12-17 |
| 1295219939 | Jennifer Dorough | Nurse Practitioner | 400 Charter Blvd, Macon, GA 31210-4831 | 2018-09-19 |
| 1104326271 | Martha Katherine Lennington | Physician Assistant | 400 Charter Blvd, Macon, GA 31210-4831 | 2018-02-15 |
| 1316455751 | Cessalee Ann Swars | Nurse Practitioner | 400 Charter Blvd, Macon, GA 31210-4831 | 2018-01-19 |
| 1578071387 | Jessica Danielle Olavarria | Nurse Practitioner | 400 Charter Blvd, Macon, GA 31210-4831 | 2018-01-15 |
| 1235504192 | Charter Inpatient Services LLC | Nurse Practitioner | 400 Charter Blvd, Macon, GA 31210-4831 | 2015-12-03 |
| 1144693920 | Appleseed Emergency Physicians, LLC | Physician Assistant | 400 Charter Blvd, Macon, GA 31210-4831 | 2015-11-03 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033743455 | Dana Elizabeth Toth | Nurse Practitioner | 5300 Bowman Rd, Macon, GA 31210 | 2020-02-25 |
| 1871124735 | Jessica Bello | Nurse Practitioner | 5300 Bowman Road, Macon, GA 31210 | 2020-01-30 |
| 1225505787 | Rebekah Hollinshead | Occupational Therapist | Therapy Specialists of Georgia, 4116 Arkwright Road, Macon, GA 31210 | 2018-11-01 |
| 1346744943 | Ace Medical Transport LLC. | Ambulance | 728 Gay Dr, Macon, GA 31210 | 2018-03-20 |
| 1972965226 | Omar Faruk Ahmad | Family Medicine | 3400 Riverside Drvie, Macon, GA 31210 | 2016-03-25 |
| 1083074868 | Macon Dentist Office, PC | Dentist | 206 Tom Hill Sr Blvd, Suite 106, Macon, GA 31210 | 2016-03-07 |
| 1992176952 | Kerisia Wasztyl | Marriage & Family Therapist | 4691 Pine Valley Dr, Macon, GA 31210 | 2015-10-15 |
| 1073905444 | Eunice Malave De Leon | Social Worker | 174 Spring St, Macon, GA 31210 | 2015-02-23 |
| 1396141545 | Axis Surgery Center LLC | Clinic/Center | 230 Sheraton Blvd, Ste B, Macon, GA 31210 | 2014-11-17 |
| 1073914115 | Monique Rechelle Delay Moore | Community/Behavioral Health | 646 Millrun Court, Macon, GA 31210 | 2014-09-09 |
| Find all providers in zip 31210 | ||||
| Taxonomy Code | 207PE0004X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| Specialization | Emergency Medical Services |
| An emergency medicine physician who specializes in non-hospital based emergency medical services (e.g., disaster site, accident scene, transport vehicle, etc.) to provide pre-hospital assessment, treatment, and transport patients. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A Certification of Added Qualifications (CAQ) is issued by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306060264 | Gary L Godlewski | Emergency Medicine | 4755 Wesleyan Woods Dr, Macon, GA 31210-4410 | 2007-04-12 |
| 1205901899 | Nalini Ramaiya | Emergency Medicine | 350 Hospital Dr, Macon, GA 31217-3838 | 2006-11-21 |
| 1093818312 | Lisa Kirkland | Emergency Medicine | 350 Hospital Dr, Macon, GA 31217-3838 | 2006-09-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528675956 | Nextgen Ems LLC | Emergency Medicine | 121 Tyre Dr, Mcdonough, GA 30253-8542 | 2020-09-29 |
| 1710506233 | Rita Udom | Emergency Medicine | 2795 Davis Rd, Marietta, GA 30062-6670 | 2020-04-14 |
| 1629463500 | Quoc Vinh Ngo | Emergency Medicine | Wellstar West Georgia Medical Center, 1504 Vernon Road, Lagrange, GA 30240 | 2015-03-30 |
| 1831539253 | Andrew Wesley White | Emergency Medicine | 1120 15th St # Af1006, Augusta, GA 30912-4500 | 2013-06-29 |
| 1013141118 | Darren Deandre Naugles | Emergency Medicine | 8920 Firestone Cir, Duluth, GA 30097-6627 | 2009-05-05 |
| 1437393667 | Donald R. Dalbey | Emergency Medicine | 3725 Sweetwater Drive, Cumming, GA 30041 | 2009-05-01 |
| 1346411667 | Harvey E Schuck | Emergency Medicine | 427 Brentwood Dr Ne, Atlanta, GA 30305-3204 | 2008-03-14 |
| 1639364011 | Srihari Rao Malempati | Emergency Medicine | 535 Trimble Lake Ct Ne, Atlanta, GA 30342-2481 | 2007-09-10 |
| 1710030002 | Robert Lee Carlson Jr. | Emergency Medicine | 3900 Legacy Park Blvd Nw, Suite C-100, Kennesaw, GA 30144-7412 | 2007-01-19 |
| 1487729992 | Lisa Tadayon | Emergency Medicine | 1000 John Fy Rd Ne, Atlanta, GA 30342-1606 | 2006-11-21 |
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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.