MRS. TAMARA LYNN WYSCAVER DIRVEN (NPI# 1780944538) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780944538 |
| Entity Type | Individual |
| Full Name | MRS. TAMARA LYNN WYSCAVER DIRVEN |
| Credential | ACNP-BC |
| Practice Address |
1348 Walton Way Ste 5700 Augusta GA 30901 |
| Mailing Address |
Po Box 1524 Augusta GA 30903-1524 |
| Practice Telephone | 7067747022 |
| Practice Fax Number | 7067747023 |
| Mailing Telephone | 7067748326 |
| Mailing Fax Number | 7067747230 |
| Enumeration Date | 2012-05-25 |
| Last Update Date | 2019-09-30 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LA2100X |
Nurse Practitioner Specialization: Acute Care |
RN287474 | GA | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LA2100X |
Nurse Practitioner Specialization: Acute Care |
4704193954 | MI | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1348 Walton Way Ste 5700, Augusta, GA 30901 | 7067747022 | 7067747023 |
| 3990 John R St, Detroit, MI 482012018 | 3139936023 |
| Street Address |
1348 WALTON WAY STE 5700 |
| City | AUGUSTA |
| State | GA |
| Zip Code | 30901 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255321915 | Anthony Dhiantie Goei | Radiology | 1348 Walton Way Ste 5700, Augusta, GA 30901-5110 | 2005-10-25 |
| 1831754738 | Jennifer T Reid | Nurse Practitioner | 1348 Walton Way Ste 5700, Augusta, GA 30901-5110 | 2019-05-06 |
| 1477090900 | Renee Fritz | Physician Assistant | 1348 Walton Way Ste 5700, Augusta, GA 30901 | 2017-01-23 |
| 1952765018 | Rebekah Scout Sanders | Nurse Practitioner | 1348 Walton Way Ste 5700, Augusta, GA 30901-5110 | 2016-04-05 |
| 1770835522 | Justin Michael Croft | Physician Assistant | 1348 Walton Way Ste 5700, Augusta, GA 30901-5110 | 2012-10-03 |
| 1649534314 | Julyn Kendra Burton | Nurse Practitioner | 1348 Walton Way Ste 5700, Augusta, GA 30901-5110 | 2012-06-27 |
| 1154579605 | Christopher Ellington | Surgery | 1348 Walton Way Ste 5700, Augusta, GA 30901-5110 | 2008-09-08 |
| 1407036585 | Bradley Earnest Carr | Technician, Other | 1348 Walton Way Ste 5700, Augusta, GA 30901-5110 | 2007-11-06 |
| 1609815729 | William Clifford Kitchens | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 1348 Walton Way Ste 5700, Augusta, GA 30901-5110 | 2006-06-05 |
| 1285691113 | John Salvatore Anastasi | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 1348 Walton Way Ste 5700, Augusta, GA 30901 | 2006-04-26 |
| Find all providers in the same location | ||||
| 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 | 363LA2100X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Acute Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508147844 | Cassie Alexander | Nurse Practitioner | 1120 15th St # Bp-3448, Augusta, GA 30912-0004 | 2011-08-31 |
| 1700491503 | Chelsey Elana Pye | Nurse Practitioner | 820 Saint Sebastian Way Ste 7c, Augusta, GA 30901-2641 | 2020-09-09 |
| 1245857002 | Morgan Rowe | Nurse Practitioner | 1120 15th St, Augusta, GA 30912-0004 | 2020-06-28 |
| 1558993576 | Robert Steven Blackwelder | Nurse Practitioner | 1120 15th St, Augusta, GA 30912-0004 | 2020-02-07 |
| 1962055590 | Victoria Aileen Shaver | Nurse Practitioner | 3651 Wheeler Rd, Augusta, GA 30909 | 2019-07-23 |
| 1215599527 | Sherwin Goering | Nurse Practitioner | 1350 Walton Way, Augusta, GA 30901-2612 | 2019-07-08 |
| 1487214151 | Cassandra Ebony Brown | Nurse Practitioner | 2258 Wrightsboro Rd Ste 400, Augusta, GA 30904-4788 | 2019-06-16 |
| 1801354816 | Daniel Mark Perrine | Nurse Practitioner | 1120 15th St # Bi1056, Augusta, GA 30912-0004 | 2019-03-08 |
| 1346720596 | Caroline Flake | Nurse Practitioner | 1348 Walton Way Ste 6700, Augusta, GA 30901-5111 | 2018-08-17 |
| 1639655301 | James Brinson IIi | Nurse Practitioner | 1120 15th St, Augusta, GA 30912-0004 | 2018-07-16 |
| Find all providers in AUGUSTA | ||||
Please comment or provide details below to improve the information on MRS. TAMARA LYNN WYSCAVER DIRVEN.
| 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.