JUAN ISRAEL GAITAN RUEDA


Address: 1255 Highway 54 W, Fayetteville, GA 30214-4526
Phone: 4043673014

JUAN ISRAEL GAITAN RUEDA (NPI# 1720241094) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1720241094
Entity Type Individual
Full Name JUAN ISRAEL GAITAN RUEDA
Credential MD
Practice Address 1255 Highway 54 W
Fayetteville
GA 30214-4526
Practice Telephone 4043673014
Mailing Telephone 4043673014
Enumeration Date 2008-07-08
Last Update Date 2017-01-02
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 207RC0200X Internal Medicine
Specialization: Critical Care Medicine
076716 GA Allopathic & Osteopathic Physicians
Y 207RP1001X Internal Medicine
Specialization: Pulmonary Disease
076716 GA Allopathic & Osteopathic Physicians

Office Location

Street Address 1255 HIGHWAY 54 W
City FAYETTEVILLE
State GA
Zip Code 30214-4526

Providers in the same location

NPI Name Taxonomy Address Enumeration
1790759579 Terrence Wise Internal Medicine 1255 Highway 54 W, Fayetteville, GA 30214-4526 2006-02-16
1518575737 Lillie La Marre Anesthesiologist Assistant 1255 Highway 54 W, Fayetteville, GA 30214-4526 2020-07-14
1932723285 Janam Nilesh Patel Anesthesiologist Assistant 1255 Highway 54 W, Fayetteville, GA 30214-4526 2020-06-02
1851934541 Kara Elizabeth Wright Registered Nurse 1255 Highway 54 W, Fayetteville, GA 30214-4526 2019-10-24
1093370827 Virginia Ann Horan Physician Assistant 1255 Highway 54 W, Fayetteville, GA 30214-4526 2019-05-07
1588123285 Morgan Roberson Nurse Practitioner 1255 Highway 54 W, Fayetteville, GA 30214-4526 2019-03-13
1174099410 Ellen Marie Morris-white Nurse Practitioner 1255 Highway 54 W, Fayetteville, GA 30214-4526 2018-10-14
1851874085 Monika Hill Nurse Practitioner 1255 Highway 54 W, Fayetteville, GA 30214-4526 2018-09-13
1700368958 Kristen Dawn Graddy Occupational Therapist 1255 Highway 54 W, Fayetteville, GA 30214-4526 2018-09-04
1407342603 Mary Grace B Nuega Nurse Practitioner 1255 Highway 54 W, Fayetteville, GA 30214-4526 2018-07-11
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1548872468 Phyllis Kelly Wood Nurse Practitioner 217 Banks Rd, Suite 31, Fayetteville, GA 30214 2020-08-21
1073139317 Tyisha Salter Scott Counselor 110 Habersham Drive, Suite 142, Fayetteville, GA 30214 2020-06-23
1194341412 Camille Franncine Bolton Physical Therapist 500 Floy Farr Parkway, Suite 303, Fayetteville, GA 30214 2020-06-23
1205465895 Gillian Vaughan Heard Physician Assistant 1275 Ga-54 #201, Fayetteville, GA 30214 2020-04-06
1881234557 Peach Fits,inc Mastectomy Fitter 285 Glynn Street South, Suites 102 and 104, Fayetteville, GA 30214 2020-01-10
1255981072 Delta Healthcare Providers Clinic/Center 1275 W Lanier Ave, #200, Fayetteville, GA 30214 2019-09-13
1861965592 Hierarchy for Wellness Specialist 805 S Glynn St Bldg 127 142, Fayetteville, GA 30214 2019-01-04
1356810634 Fayette Dental Group PC Clinic/Center 720 W Lanier Ave, Fayetteville, GA 30214 2018-11-16
1891263299 Mattie Mae Farmer Clark Specialist/Technologist, Other Piedmont Fayette Hospital, 1255 Highway 54 West, Fayetteville, GA 30214 2018-11-05
1093293607 Allyson Holland Pharmacist 880 Highway 85 South, Fayetteville, GA 30214 2018-08-06
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Taxonomy Information

Taxonomy Code 207RP1001X
Grouping Allopathic & Osteopathic Physicians
Classification Internal Medicine
Specialization Pulmonary Disease

Taxonomy Definition

An internist who treats diseases of the lungs and airways. The pulmonologist diagnoses and treats cancer, pneumonia, pleurisy, asthma, occupational and environmental diseases, bronchitis, sleep disorders, emphysema and other complex disorders of the lungs.
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 Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification
- Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1952643157 Rahim Wooley Internal Medicine 1265 Highway 54 W Ste 500a, Fayetteville, GA 30214-4556 2013-03-26
1215463450 Cumberland County Hospital System Inc Internal Medicine 1201 Walter Reed Rd, Fayetteville, NC 28304-4437 2017-05-09
1558701847 Ashlie Arthur Internal Medicine 1265 Highway 54 W Ste 500a, Fayetteville, GA 30214 2013-07-01
1245243690 Douglas Wayne Whetsell Internal Medicine 413 Owen Dr, Suite 202, Fayetteville, NC 28304-3489 2006-08-15
1699703496 Jon A Sexton Internal Medicine 3344 N Futrall Dr, Fayetteville, AR 72703-4057 2006-06-29
1548298466 Michael Alan Eckles Internal Medicine 3344 N Futrall Dr, Fayetteville, AR 72703 2006-06-29
1427094390 Kyle G Hardy Internal Medicine 3344 N Futrall Dr, Fayetteville, AR 72703-4057 2006-06-21
1477599389 Gary L Templeton Internal Medicine 3344 N Futrall Dr, Fayetteville, AR 72703-4057 2006-06-20
1003851072 Kim R Agee Internal Medicine 3344 N Futrall Dr, Fayetteville, AR 72703-4057 2006-06-16
1821038209 Rahul Kumar Kakkar Internal Medicine 200 Forsythe St, Fayetteville, NC 28303-5426 2006-06-07
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Competitor

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City FAYETTEVILLE
Zip Code 30214

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Dataset Information

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.

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