BETH SCOGGAN COSTOLNICK (NPI# 1740598648) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1740598648 |
| Entity Type | Individual |
| Full Name | BETH SCOGGAN COSTOLNICK |
| Other Name | BETH ANNE SCOGGAN |
| Credential | PA-C |
| Practice Address |
550 Professional Dr Macon GA 31201-1411 |
| Practice Telephone | 4787413007 |
| Practice Fax Number | 4787551547 |
| Mailing Telephone | 4787413007 |
| Mailing Fax Number | 4787551547 |
| Enumeration Date | 2010-09-14 |
| Last Update Date | 2012-03-27 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
1094738 | GA | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | TAXPAYER IDENTIFICATION NUMBER | 582409645 | 01 |
| Street Address |
550 PROFESSIONAL DR |
| City | MACON |
| State | GA |
| Zip Code | 31201-1411 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578539649 | Jennifer Campbell | Nurse Practitioner | 550 Professional Dr, Macon, GA 31201-1411 | 2006-02-27 |
| 1821569716 | Keilah Wynn Jones | Nurse Practitioner | 550 Professional Dr, Macon, GA 31201-1411 | 2018-12-17 |
| 1508348756 | David Toth Jr. | Nurse Practitioner | 550 Professional Dr, Macon, GA 31201-1411 | 2018-09-04 |
| 1962917773 | Amy Wood | Nurse Practitioner | 550 Professional Dr, Macon, GA 31201-1411 | 2017-12-04 |
| 1952750374 | Stephanie Anne Wilcox | Nurse Practitioner | 550 Professional Dr, Macon, GA 31201-1411 | 2016-06-07 |
| 1245621705 | Stefanie Smith Tate | Nurse Practitioner | 550 Professional Dr, Macon, GA 31201-1411 | 2015-02-05 |
| 1588072334 | Carrie Smith | Nurse Practitioner | 550 Professional Dr, Macon, GA 31201-1411 | 2014-07-24 |
| 1215371489 | Julia Elizabeth Yawn | Nurse Practitioner | 550 Professional Dr, Macon, GA 31201-1411 | 2013-04-18 |
| 1194092817 | Hollie R Holloway | Nurse Practitioner | 550 Professional Dr, Macon, GA 31201-1411 | 2011-11-23 |
| 1629352018 | Abby Greer Weldon | Nurse Practitioner | 550 Professional Dr, Macon, GA 31201-1411 | 2011-10-04 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639666340 | Yasameen Emad Muzahim | Internal Medicine | 777 Hemlock Street, Msc 165, Macon, GA 31201 | 2018-04-18 |
| 1952819419 | Putnam Dialysis LLC | Clinic/Center | 657 Hemlock Street, Suite 200, Macon, GA 31201 | 2018-01-18 |
| 1730604331 | Graham Arthur Mercier | Surgery | 169 Ashley Ave., Room 202 Main Hospital Msc 333, Charleston, SC 31201 | 2017-08-04 |
| 1376075705 | Diamond Jude | Internal Medicine | 777 Hemlock Street Msc #104, Macon, GA 31201 | 2017-04-03 |
| 1174055263 | Carol Roobin Bashuk | Hearing Instrument Specialist | 634 First Street, Macon, GA 31201 | 2017-03-29 |
| 1144752411 | Hubert Pare | Student in an Organized Health Care Education/Training Program | 777 Hemlock Street, Msc# 165, Macon, GA 31201 | 2017-03-28 |
| 1548613789 | Michael Daugherty | Counselor | 1873 Hardeman Ave, Suite 1, Macon, GA 31201 | 2016-07-22 |
| 1316317993 | 4front Healthcare of Middle Georgia, LLC | Hospice Care, Community Based | 682 1st St, Macon, GA 31201 | 2015-09-25 |
| 1881073054 | Andrew Lee Drahos | Surgery | 777 Hemlock St # 140, Macon, GA 31201 | 2015-05-21 |
| 1720474158 | April Nicole Colley | Nurse Practitioner | 1014 Forsyth Street, Macon, GA 31201 | 2015-04-13 |
| Find all providers in zip 31201 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033309075 | Heidi Mans Atkins | Physician Assistant | 556 3rd St Ste A, Macon, GA 31201 | 2007-07-26 |
| 1982648200 | Gretchen D Suk | Physician Assistant | 1062 Forsyth St, Suite 1b, Macon, GA 31201-8637 | 2006-06-16 |
| 1295732576 | Christine Harrell | Physician Assistant | 1062 Forsyth St Ste 2e, Macon, GA 31201-8631 | 2005-07-01 |
| 1548265549 | Rallie D Cogburn Sr. | Physician Assistant | 6070 Lakeside Commons Dr, Macon, GA 31210-5778 | 2005-06-16 |
| 1942845375 | Emily Kerns | Physician Assistant | 1201 N Rutherford St, Macon, MO 63552-2020 | 2019-11-08 |
| 1245708072 | Amberly Hardison | Physician Assistant | 124 3rd St, Macon, GA 31201-3404 | 2018-11-09 |
| 1407266968 | Patricia Frances Baldwin | Physician Assistant | 400 Charter Blvd, Macon, GA 31210-4831 | 2014-05-05 |
| 1033405477 | Rachel Hinson Youngblood | Physician Assistant | 800 1st St Ste 410, Macon, GA 31201-8306 | 2011-06-23 |
| 1134452568 | Deana J Porter | Physician Assistant | 210 Mercer Jct, Macon, GA 31210-4016 | 2009-09-17 |
| 1962634451 | Harry Tinley (tim) Reynolds | Physician Assistant | 556 3rd St, Suite A, Macon, GA 31201-7934 | 2009-08-17 |
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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.