MALLORY ANN LEDERGERBER (NPI# 1720502230) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720502230 |
| Entity Type | Individual |
| Full Name | MALLORY ANN LEDERGERBER |
| Credential | PA-C |
| Practice Address |
60 Exchange St Ste B7 Richmond Hill GA 31324-7646 |
| Mailing Address |
10 Elm Grove Crossing Mall Wheeling WV 26003-5300 |
| Practice Telephone | 9127562273 |
| Practice Fax Number | 9127563773 |
| Enumeration Date | 2017-07-27 |
| Last Update Date | 2019-12-10 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 2074 | GA | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363A00000X | Physician Assistant | 2074 | WV | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
60 EXCHANGE ST STE B7 |
| City | RICHMOND HILL |
| State | GA |
| Zip Code | 31324-7646 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982603064 | Whitney L. Rintelman | Physician Assistant | 60 Exchange St Ste B7, Richmond Hill, GA 31324-7646 | 2005-07-20 |
| 1336647957 | Sequoyah Smith Brown | Nurse Practitioner | 60 Exchange St Ste B7, Richmond Hill, GA 31324-7646 | 2018-01-29 |
| 1699142471 | Jeanine Onischuck | Nurse Practitioner | 60 Exchange St Ste B7, Richmond Hill, GA 31324-7646 | 2015-08-27 |
| 1821233354 | The Urgent Care Center of Richmond Hill, LLC | Clinic/Center | 60 Exchange St Ste B7, Richmond Hill, GA 31324-7646 | 2008-12-12 |
| 1740394782 | Jeffrey D Morgan | Physician Assistant | 60 Exchange St Ste B7, Richmond Hill, GA 31324 | 2006-08-18 |
| 1013906130 | Carey L. Christiansen Ford | Emergency Medicine | 60 Exchange St Ste B7, Richmond Hill, GA 31324-7646 | 2005-10-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902389588 | Bryan Anderson | Physician Assistant | 8435 Vanguard Road, Fort Stewart, GA 31324 | 2018-09-10 |
| 1366941684 | Codie Wiley | Physician Assistant | Expercare Urgent Care 60 Exchange Street, Suite B7, Richmond Hill, GA 31324 | 2018-02-02 |
| 1174038145 | Shelly Stewart Childers | Nurse Practitioner | 2453 U.S. 17, Suite G, Richmond Hill, GA 31324 | 2017-12-12 |
| 1619495215 | Kristi Oxley | Nurse Practitioner | 2701 Us Hwy 17 Ste 1b, Richmond Hill, GA 31324 | 2017-09-03 |
| 1275062564 | Janice Tillman Gravitt | Registered Nurse | 60 Long Creek Lane, Richmond Hill, GA 31324 | 2017-06-08 |
| 1336680065 | Choice Care Medical | Durable Medical Equipment & Medical Supplies | 9390 Ford Ave Ste 9, Richmond Hill, GA 31324 | 2017-03-14 |
| 1750730263 | Haralabos Saltourides | Physical Therapy Assistant | 127 Carter Street, Richmond Hill, GA 31324 | 2016-06-06 |
| 1922462464 | Leia Edenfield | Student in an Organized Health Care Education/Training Program | 105 Balfour Dr, Richmond Hill, GA 31324 | 2016-04-11 |
| 1477931384 | Stephanie Eileen Banasik | Nurse Practitioner | 10200 Ford Ave. Ste. 101, Richmond Hill, GA 31324 | 2015-05-12 |
| 1962800771 | Kendra Seagraves | Nurse Practitioner | 9976 Ford Avenue, Richmond Hill, GA 31324 | 2014-12-10 |
| Find all providers in zip 31324 | ||||
| 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 |
|---|---|---|---|---|
| 1124642962 | Kiran Kazmi | Physician Assistant | 8628 131st St, Richmond Hill, NY 11418-2633 | 2020-06-07 |
| 1366941684 | Codie Wiley | Physician Assistant | Expercare Urgent Care 60 Exchange Street, Suite B7, Richmond Hill, GA 31324 | 2018-02-02 |
| 1881133783 | Miriam Epstein | Physician Assistant | 11702 Curzon Rd, Richmond Hill, NY 11418-3483 | 2017-02-13 |
| 1639591555 | Andrew Riofrio | Physician Assistant | 9107 108th St, Richmond Hill, NY 11418-2232 | 2014-01-12 |
| 1134265192 | Padma Persaud | Physician Assistant | 113 02 107 Avenue, Richmond Hill, NY 11419 | 2007-01-29 |
| 1528051232 | Lori Bernard Gaylor | Physician Assistant | 60 Exchange St, Suite B-7, Richmond Hill, GA 31324 | 2005-08-27 |
| 1982603064 | Whitney L. Rintelman | Physician Assistant | 60 Exchange St Ste B7, Richmond Hill, GA 31324-7646 | 2005-07-20 |
| 1023017795 | Catherine Corish Grant | Physician Assistant | 60 Exchange Street, Suite B-7, Richmond Hill, GA 31324 | 2005-07-15 |
| 1285279760 | Fatima Akbar | Physician Assistant | 12108 Hillside Ave, Richmond Hill, NY 11418-1812 | 2019-11-08 |
| 1629561485 | Oleg Alenichko | Physician Assistant | 8900 Van Wyck Expy, Richmond Hill, NY 11418-2832 | 2018-06-07 |
| Find all providers in RICHMOND HILL | ||||
| City | RICHMOND HILL |
| Zip Code | 31324 |
Please comment or provide details below to improve the information on MALLORY ANN LEDERGERBER.
| 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.