MRS. ANGELA CUDGER KENMEGNE (NPI# 1720376833) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720376833 |
| Entity Type | Individual |
| Full Name | MRS. ANGELA CUDGER KENMEGNE |
| Credential | PA-A |
| Practice Address |
380 Hospital Dr Suite 410 Macon GA 31217 |
| Mailing Address |
Po Box 2564 Macon GA 31203-2564 |
| Practice Telephone | 4787465644 |
| Practice Fax Number | 4787454849 |
| Mailing Telephone | 4787465644 |
| Enumeration Date | 2011-07-11 |
| Last Update Date | 2013-09-23 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 367H00000X | Anesthesiologist Assistant | 6865 | GA | Physician Assistants & Advanced Practice Nursing Providers |
| N | 367H00000X | Anesthesiologist Assistant | 1255 | NC | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 003135897A | 05 | |
| GA | 003135897B | 05 | |
| GA | 003135897D | 05 | |
| GA | AMERIGROUP | 01869603 | 01 |
| GA | 003135897C | 05 |
| Street Address |
380 HOSPITAL DR SUITE 410 |
| City | MACON |
| State | GA |
| Zip Code | 31217 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841286978 | Harvey Burton Roddenberry | Obstetrics & Gynecology | 380 Hospital Dr, Suite 100, Macon, GA 31217-8001 | 2005-09-23 |
| 1225664378 | Mattie Larae Erby | Student in an Organized Health Care Education/Training Program | 380 Hospital Dr, Building A, Suite 430, Macon, GA 31217 | 2020-03-20 |
| 1386209815 | Adelina Roxana Buganu | Emergency Medicine | 380 Hospital Dr, Macon, GA 31217-8001 | 2019-05-09 |
| 1396278933 | Brandon Kirshner | Internal Medicine | 380 Hospital Dr, Suite 380, Macon, GA 31217-8001 | 2017-04-11 |
| 1033643572 | Nicholas Monaco | Student in an Organized Health Care Education/Training Program | 380 Hospital Dr, Suite 430, Macon, GA 31217-8001 | 2017-04-11 |
| 1013440957 | Ruth Osondu | Student in an Organized Health Care Education/Training Program | 380 Hospital Dr, Stuite 430 Coliseum Medical Centers, Macon, GA 31217-8017 | 2017-04-07 |
| 1528591443 | Tamie Wells | Student in an Organized Health Care Education/Training Program | 380 Hospital Dr, Suite 430, Macon, GA 31217-8001 | 2017-04-07 |
| 1205369253 | Ivania Trinidad Irby | Student in an Organized Health Care Education/Training Program | 380 Hospital Dr, Bldg A, Ste 430, Macon, GA 31217-8001 | 2017-04-06 |
| 1679005730 | Anum Amir Niazi | Internal Medicine | 380 Hospital Dr, Suite 430, Macon, GA 31217-8001 | 2017-03-29 |
| 1497286900 | Muhammad Uneib | Student in an Organized Health Care Education/Training Program | 380 Hospital Dr, Suite 430, Macon, GA 31217-8001 | 2017-03-26 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326535998 | Khuzema Mohsin | Student in an Organized Health Care Education/Training Program | 380 Hospital Drive, Building A, Suite 430, Macon, GA 31217 | 2018-04-18 |
| 1083135271 | Angela Polk | Nurse Practitioner | 310 Hospital Dr Ste 305, Macon, GA 31217 | 2017-06-28 |
| 1235662305 | Natalie Rodziewicz | Student in an Organized Health Care Education/Training Program | 380 Hospital Drive, Suite 430, Macon, GA 31217 | 2017-04-06 |
| 1427430180 | Brett Forehand | Nurse Practitioner | 330 Hospital Dr Ste 304, Macon, GA 31217 | 2015-06-18 |
| 1376772640 | Beverly Barksdale Sanders IIi | Internal Medicine | 330 Hospital Dr., Ste. 304, Macon, GA 31217 | 2009-07-08 |
| 1528218393 | Vladimir Zahradnik | Surgery | 380 Hospital Dr Bldg A Ste 320, Macon, GA 31217 | 2008-09-29 |
| 1821274267 | Mary Charmaine Estrella Campana | Physical Therapist | 380 Hospital Drive, Building A, Ste. 430, Macon, GA 31217 | 2008-01-16 |
| 1033300785 | Joann Sams Sinclair | Nurse Practitioner | 4164 Riggins Mill Road, Macon, GA 31217 | 2007-08-07 |
| 1376689737 | Grier Godfrey | Dentist | Macon-bibb County Health Department, 171 Emery Highway, Macon, GA 31217 | 2007-01-30 |
| 1053408328 | Sujatha K. Reddy | Psychiatry & Neurology | 175 Emery Highway, Macon, GA 31217 | 2006-10-06 |
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| Taxonomy Code | 367H00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Anesthesiologist Assistant |
| An individual certified by the state to perform anesthesia services under the direct supervision of an anesthesiologist. Anesthesiologist Assistants are required to have a bachelor's degree with a premed curriculum prior to entering a two-year anesthesiology assistant program, which is focused upon the delivery and maintenance of anesthesia care as well as advanced patient monitoring techniques. An Anesthesiologist Assistant must work as a member of the anesthesia care team under the direction of a qualified Anesthesiologist. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801446455 | Mednax | Anesthesiologist Assistant | 770 Pine St Ste L40, Macon, GA 31201-7521 | 2019-09-16 |
| 1689895591 | David Luce | Anesthesiologist Assistant | 777 Hemlock Street, Macon, GA 31201 | 2007-05-01 |
| 1306814249 | Catherine D Davis | Anesthesiologist Assistant | 624 Bellgrove Pt, Macon, GA 31220-7621 | 2006-03-08 |
| 1669081113 | Sabrina L. Singleton | Anesthesiologist Assistant | 777 Hemlock St, Macon, GA 31201-2102 | 2020-07-29 |
| 1952932881 | Shelby Laray Kelley | Anesthesiologist Assistant | 777 Hemlock St, Macon, GA 31201-2102 | 2020-01-29 |
| 1407494636 | Tyler Brice Akins | Anesthesiologist Assistant | 777 Hemlock St, Macon, GA 31201-2102 | 2019-12-18 |
| 1205486362 | Alie Mulkey | Anesthesiologist Assistant | 770 Pine St Ste L40, Macon, GA 31201-7521 | 2019-09-19 |
| 1548778392 | Samantha Ryce Dillon | Anesthesiologist Assistant | 777 Hemlock St, Macon, GA 31201-2102 | 2018-01-15 |
| 1306356860 | Jesse Michael | Anesthesiologist Assistant | 380 Hospital Dr Ste 410, Macon, GA 31217-8014 | 2017-10-10 |
| 1487106548 | Caitlin Emily George | Anesthesiologist Assistant | 777 Hemlock St, Macon, GA 31201-2102 | 2016-10-25 |
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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.