FALCON MEDICAL GROUP (NPI# 1770865396) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770865396 |
| Entity Type | Organization |
| Organization Name | FALCON MEDICAL GROUP |
| Other Organization Name | VICTORY PAIN MANAGEMENT |
| Practice Address |
1301 Broad St Suite 102 Augusta GA 30901-1055 |
| Mailing Address |
Po Box 12308 Augusta GA 30914-2308 |
| Practice Telephone | 7067235894 |
| Enumeration Date | 2011-09-10 |
| Last Update Date | 2013-04-15 |
| Authorized Official Name | MR. CHRISTOPHER SCOTT JACKSON (ORGANIZER) |
| Authorized Official Telephone | 7069519050 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | Other Service Providers |
| Other Name | Type Code |
|---|---|
| Victory Pain Management | Doing Business As Name - Organization |
| Street Address |
1301 BROAD ST SUITE 102 |
| City | AUGUSTA |
| State | GA |
| Zip Code | 30901-1055 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609828094 | Scott D Pethke | Internal Medicine | 1301 Broad St, Augusta, GA 30901-1055 | 2006-05-16 |
| 1184190647 | Melissa Renee Broske | Nurse Practitioner | 1301 Broad St, Augusta, GA 30901-1055 | 2018-10-22 |
| 1902332711 | Rite Care Pharmacy LLC | Pharmacy | 1301 Broad St, Suite 200, Augusta, GA 30901-1055 | 2017-05-11 |
| 1619043049 | Augusta Lung Associates | Specialist | 1301 Broad St, Augusta, GA 30901-1055 | 2006-11-28 |
| 1366528333 | Varsha Anant Kulkarni | Internal Medicine | 1301 Broad St, Augusta, GA 30901-1055 | 2006-10-31 |
| 1902821135 | Alfred Lynne Brannen II | Internal Medicine | 1301 Broad St, Augusta, GA 30901-1055 | 2006-07-12 |
| 1619992849 | Michael Steward Haynes | Internal Medicine | 1301 Broad St, Augusta, GA 30901-1055 | 2006-07-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477019925 | Courtney Erin Fairchild | Physician Assistant | 1101 15th Street, Pa-224, Augusta, GA 30901 | 2019-02-20 |
| 1699263921 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 1022 Walton Way Spc C, Augusta, GA 30901 | 2018-04-23 |
| 1235684192 | Heather Raborn | Allergy & Immunology | 1350 Walton Way Ste 5100, Augusta, GA 30901 | 2016-08-22 |
| 1457690745 | Rehab Without Walls, Inc. | In Home Supportive Care | 820 St Sebastin Way Se, Augusta, GA 30901 | 2013-02-06 |
| 1861788051 | Christina Weidner Belcher | Physical Therapist | 1246 Pine St, Augusta, GA 30901 | 2011-06-25 |
| 1750695979 | C H Martin Company | Durable Medical Equipment & Medical Supplies | 1456 Walton Way Suite B, Augusta, GA 30901 | 2010-07-29 |
| 1366773905 | Csb of East Central Ga | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 4027 Wheeler Rd, Augusta, GA 30901 | 2010-01-21 |
| 1851622484 | Csb of East Central Ga | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1715 Forest Drive, Augusta, GA 30901 | 2010-01-21 |
| 1760615280 | Absolute Family PCh | Point of Service | 2035 Old Savannah Rd., Augusta, GA 30901 | 2009-09-01 |
| 1073740643 | Ryan J Altenburg | Internal Medicine | 820 Saint Sebastian Way Ste 8a, Augusta, GA 30901 | 2009-06-22 |
| Find all providers in zip 30901 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164056859 | Bimal R Shah Md PC | Specialist | 820 Saint Sebastian Way Ste 2a, Augusta, GA 30901-2636 | 2020-03-03 |
| 1407319676 | Tavories Ivey Sr. | Specialist | 4409 Silverton Rd, Augusta, GA 30909-9122 | 2019-04-12 |
| 1346708849 | Debra Imani Simms | Specialist | 519 Pleasant Home Rd Ste A1, Augusta, GA 30907-0545 | 2019-03-04 |
| 1821522715 | Amber Mccray | Specialist | 270 Bobby Jones Expy Ste 158, Augusta, GA 30907-3086 | 2017-04-18 |
| 1508231978 | Robert Jason Mitchell | Specialist | 950 15th St Rm 3c164, Augusta, GA 30901-2608 | 2015-12-10 |
| 1548654411 | Donecia Perrin-sullivan | Specialist | 524 Shartom Dr, Augusta, GA 30907-4751 | 2015-03-27 |
| 1396133153 | Veronica Ann Mccarthy | Specialist | 66 Hilltop Ln, Augusta, MI 49012-9502 | 2015-01-02 |
| 1225379738 | Dawn K Johnson | Specialist | 901 Bridge Creek Ln, Augusta, WI 54722-2603 | 2013-03-07 |
| 1962748210 | Helen Bryngelson | Specialist | 3581 Stevens Way, Augusta, GA 30907-9560 | 2012-12-13 |
| 1831469899 | Tanya Bernadette Quarterman | Specialist | 153 Hospital St Ste 13, Augusta, ME 04330 | 2012-01-09 |
| Find all providers in AUGUSTA | ||||
Please comment or provide details below to improve the information on FALCON MEDICAL GROUP.
| 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.