MR. ALLEN MICHAEL BLACKBURN COSTA (NPI# 1740690924) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1740690924 |
| Entity Type | Individual |
| Full Name | MR. ALLEN MICHAEL BLACKBURN COSTA |
| Credential | MD |
| Practice Address |
Emory University Hospital 1364 Clifton Rd. Ne Atlanta GA 30332-1064 |
| Practice Telephone | 4047122000 |
| Mailing Telephone | 4047122000 |
| Enumeration Date | 2014-04-28 |
| Last Update Date | 2014-04-28 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Street Address |
EMORY UNIVERSITY HOSPITAL 1364 CLIFTON RD. NE |
| City | ATLANTA |
| State | GA |
| Zip Code | 30332-1064 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700874971 | Lucius Courtenay Beebe Sr. | Urology | Emory University Hospital, 1364 Clifton Rd Ne, Atlanta, GA 30322-1059 | 2005-10-11 |
| 1629423173 | Cheryl Castleberry | Registered Nurse | Emory University Hospital, 1364 Clifton Rd Operating Room, Atlanta, GA 30322-0001 | 2016-05-03 |
| 1225492200 | David Sean Thylur | Psychiatry & Neurology | Emory University Hospital, 1364 Clifton Rd., Atlanta, GA 30322-0001 | 2016-04-06 |
| 1700263407 | Ryan Dolan | Surgery | Emory University Hospital, 1364 Clifton Road, Suite D112, Atlanta, GA 30322-0001 | 2015-05-01 |
| 1972917045 | Bruno B Lima | Student in an Organized Health Care Education/Training Program | Emory University Hospital, 1364 Clifton Rd Ne, Atlanta, GA 30322 | 2014-06-17 |
| 1376963413 | Sarah Michelle Debrey | Psychiatry & Neurology | Emory University Hospital, 1364 Clifton Road, Atlanta, GA 30322-1059 | 2014-04-16 |
| 1720421910 | Amisha S Mehta | Hospitalist | Emory University Hospital, 1364 Clifton Rd Ne, Atlanta, GA 30322-1064 | 2013-04-08 |
| 1629340526 | Michael R. Rossi | Pathology | Emory University Hospital, Department of Pathology, Room H185, Atlanta, GA 30322-0001 | 2012-02-08 |
| 1932330495 | Esther Ximena Vivas | Otolaryngology | Emory University Hospital, 1364 Clifton Road, Ne, Atlanta, GA 30322-0001 | 2009-08-01 |
| 1821222308 | Angela Cheng | Plastic Surgery | Emory University Hospital, 1364 Clifton Rd, Ne, Atlanta, GA 30322-0001 | 2009-05-12 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013570415 | Michael Charles Horwath | Student in an Organized Health Care Education/Training Program | 1364 Clifton Road Ne Rm H-184, Atlanta, GA 30332 | 2019-04-21 |
| 1124311212 | Colin Michael Segovis | Radiology | Emory University 1364 Clifton Rd Ne, Atlanta, GA 30332 | 2011-05-23 |
| 1538467014 | Angelo Galante | Family Medicine | 740 Ferst Dr, Atlanta, GA 30332 | 2011-03-07 |
| 1053973313 | Robert Chavis | Specialist/Technologist | 150 Bobby Dodd Way Edge Building Athletic Training Room, Atlanta, GA 30332-0001 | 2019-07-07 |
| 1588158513 | Nesha Natasha Defoe | Behavioral Analyst | 2145 Kenridge Pkwy, Atlanta, GA 30332-0001 | 2018-06-22 |
| 1225561343 | Timothy Powers Quinn | Student in an Organized Health Care Education/Training Program | Department of Urology 1365 Clifton Rd Ne, Building B, Suite 400, Atlanta, GA 30332-0001 | 2017-04-05 |
| 1871716654 | James Edwin Behrens | Optometrist | 350 Ferst Dr Nw, Atlanta, GA 30332-0001 | 2007-04-10 |
| 1760434617 | Josephine Y. Lee | Specialist/Technologist | Georgia Tech Athletic Association, 150 Bobby Dodd Way, Nw, Atlanta, GA 30332-0001 | 2006-05-17 |
| 1073571410 | Paul Wolkoff | Specialist/Technologist | 150 Bobby Dodd Way, Atlanta, GA 30332-0001 | 2006-05-03 |
| 1740241520 | Timothy Emil Hansen | Specialist/Technologist | 150 Bobby Dodd Way Nw, Atlanta, GA 30332-0001 | 2006-03-31 |
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| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417563909 | Josephine Almanzar | Student in an Organized Health Care Education/Training Program | 199 Armour Dr Ne Ste E, Atlanta, GA 30324-3973 | 2020-09-20 |
| 1013532597 | Ivy Elizabeth Cook | Student in an Organized Health Care Education/Training Program | 3121 Flowers Rd S Apt I, Atlanta, GA 30341-5648 | 2020-06-10 |
| 1265055495 | Jeffrey Quinn Taylor II | Student in an Organized Health Care Education/Training Program | 1365 Clifton Rd Ne # 2300b, Atlanta, GA 30322-1013 | 2020-05-21 |
| 1073134391 | Robert Shvarts | Student in an Organized Health Care Education/Training Program | 465 Memorial Dr Se Unit 346, Atlanta, GA 30312-2229 | 2020-04-27 |
| 1477173920 | Ryan William Flanagan | Student in an Organized Health Care Education/Training Program | 2591 Piedmont Rd Ne Apt 1531, Atlanta, GA 30324-6280 | 2020-04-24 |
| 1467071589 | Charles Thomas Reeder | Student in an Organized Health Care Education/Training Program | 1744 Logans Knl Ne, Atlanta, GA 30329-4100 | 2020-04-09 |
| 1548899743 | Chandni Patel | Student in an Organized Health Care Education/Training Program | 700 14th St Nw, Atlanta, GA 30318-5408 | 2020-04-08 |
| 1962031625 | Rachel Reed | Student in an Organized Health Care Education/Training Program | 1364 Clifton Rd Ne Ste H-100, Atlanta, GA 30322-1059 | 2020-04-05 |
| 1629606264 | Jasmine Donesha Shackelford | Student in an Organized Health Care Education/Training Program | Emory Family Medicine, 4500 North Shallowford Road, Atlanta, GA 30338 | 2020-03-30 |
| 1467080218 | Aminah Danielle Phelps | Student in an Organized Health Care Education/Training Program | 395 Saint Jacques Ct Sw, Atlanta, GA 30331-8434 | 2020-03-28 |
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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.