BETHESDA INSTITUTE OF SPINE & NEUROSURGERY (NPI# 1790211399) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790211399 |
| Entity Type | Organization |
| Organization Name | BETHESDA INSTITUTE OF SPINE & NEUROSURGERY |
| Practice Address |
420 Charter Blvd #208 Macon GA 31210-4854 |
| Practice Telephone | 3124794421 |
| Enumeration Date | 2017-05-03 |
| Last Update Date | 2017-05-03 |
| Authorized Official Name | DR. KWAME AMPONSAH (OWNER) |
| Authorized Official Telephone | 3124794421 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207T00000X | Neurological Surgery | Allopathic & Osteopathic Physicians |
| Street Address |
420 CHARTER BLVD #208 |
| City | MACON |
| State | GA |
| Zip Code | 31210-4854 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508853219 | Vito John Bagnato | Surgery | 420 Charter Blvd, Suite 103, Macon, GA 31210-4854 | 2005-09-29 |
| 1992053912 | Catherine B Butler | Counselor | 420 Charter Blvd, Suite 205, Macon, GA 31210-4854 | 2012-08-23 |
| 1508120684 | Peter O. Holliday, IIi M.d. P.C. | Neurological Surgery | 420 Charter Blvd, Ste 402, Macon, GA 31210-4854 | 2012-07-03 |
| 1235498833 | Joseph Burnette, LLC | Surgery | 420 Charter Blvd, Suite 320, Macon, GA 31210-4854 | 2012-05-16 |
| 1851660443 | Palmyra Surgical, LLC | Surgery | 420 Charter Blvd, Suite 103, Macon, GA 31210-4854 | 2011-12-28 |
| 1124269089 | P O Holliday IIi Family Leasing Co LLC | Durable Medical Equipment & Medical Supplies | 420 Charter Blvd, Ste 402, Macon, GA 31210-4854 | 2009-03-23 |
| 1528231602 | Rebecca L Bass Md - Pulmonary Medicine PC | Specialist | 420 Charter Blvd, Suite 302, Macon, GA 31210-4854 | 2008-04-09 |
| 1134248149 | Alan Paul Deese | Internal Medicine | 420 Charter Blvd, Suite 405, Macon, GA 31210-4854 | 2007-03-29 |
| 1861532103 | Rebecca Lynn Bass | Specialist | 420 Charter Blvd, Suite 302, Macon, GA 31210-4854 | 2007-02-07 |
| 1780750992 | Alan P Deese Md PC | Internal Medicine | 420 Charter Blvd, Suite 405, Macon, GA 31210 | 2006-11-28 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033743455 | Dana Elizabeth Toth | Nurse Practitioner | 5300 Bowman Rd, Macon, GA 31210 | 2020-02-25 |
| 1871124735 | Jessica Bello | Nurse Practitioner | 5300 Bowman Road, Macon, GA 31210 | 2020-01-30 |
| 1225505787 | Rebekah Hollinshead | Occupational Therapist | Therapy Specialists of Georgia, 4116 Arkwright Road, Macon, GA 31210 | 2018-11-01 |
| 1346744943 | Ace Medical Transport LLC. | Ambulance | 728 Gay Dr, Macon, GA 31210 | 2018-03-20 |
| 1972965226 | Omar Faruk Ahmad | Family Medicine | 3400 Riverside Drvie, Macon, GA 31210 | 2016-03-25 |
| 1083074868 | Macon Dentist Office, PC | Dentist | 206 Tom Hill Sr Blvd, Suite 106, Macon, GA 31210 | 2016-03-07 |
| 1992176952 | Kerisia Wasztyl | Marriage & Family Therapist | 4691 Pine Valley Dr, Macon, GA 31210 | 2015-10-15 |
| 1073905444 | Eunice Malave De Leon | Social Worker | 174 Spring St, Macon, GA 31210 | 2015-02-23 |
| 1396141545 | Axis Surgery Center LLC | Clinic/Center | 230 Sheraton Blvd, Ste B, Macon, GA 31210 | 2014-11-17 |
| 1073914115 | Monique Rechelle Delay Moore | Community/Behavioral Health | 646 Millrun Court, Macon, GA 31210 | 2014-09-09 |
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| Taxonomy Code | 207T00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Neurological Surgery |
| A neurological surgeon provides the operative and non-operative management (i.e., prevention, diagnosis, evaluation, treatment, critical care, and rehabilitation) of disorders of the central, peripheral, and autonomic nervous systems, including their supporting structures and vascular supply; the evaluation and treatment of pathological processes which modify function or activity of the nervous system; and the operative and non-operative management of pain. A neurological surgeon treats patients with disorders of the nervous system; disorders of the brain, meninges, skull, and their blood supply, including the extracranial carotid and vertebral arteries; disorders of the pituitary gland; disorders of the spinal cord, meninges, and vertebral column, including those which may require treatment by spinal fusion or instrumentation; and disorders of the cranial and spinal nerves throughout their distribution. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added] Additional Resources: American Board of Neurological Surgery, 2007. http://www.abns.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Neurological Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932202066 | George S. Stefanis, Md PC | Neurological Surgery | 310 Hospital Dr Ste 205, Macon, GA 31217-8025 | 2006-09-06 |
| 1821042946 | Kevin Lee Stevenson | Neurological Surgery | 121 N Crest Blvd, Macon, GA 31210-1845 | 2006-05-22 |
| 1255985719 | Christina Stonecypher | Neurological Surgery | 840 Pine St Ste 880, Macon, GA 31201 | 2019-08-01 |
| 1306498605 | Ae Mary Irwin | Neurological Surgery | 840 Pine St Ste 880, Macon, GA 31201-7525 | 2019-07-16 |
| 1659857662 | Robert Ashley Brunson | Neurological Surgery | 840 Pine St Ste 880, Macon, GA 31201-7525 | 2018-07-12 |
| 1750890562 | Tattnall Hospital Company LLC | Neurological Surgery | 121 N Crest Blvd, Macon, GA 31210-1845 | 2017-09-25 |
| 1801243894 | Konstantinos Fountas | Neurological Surgery | 840 Pine St, Suite 880, Macon, GA 31201-2100 | 2016-05-19 |
| 1356721484 | Neurology Services of Florida | Neurological Surgery | 761 Poplar St, Ste 1-k, Macon, GA 31201-2082 | 2015-06-03 |
| 1508120684 | Peter O. Holliday, IIi M.d. P.C. | Neurological Surgery | 420 Charter Blvd, Ste 402, Macon, GA 31210-4854 | 2012-07-03 |
| 1659678555 | Richard Aurelius Smith | Neurological Surgery | 5300 Zebulon Rd, Macon, GA 31210-2199 | 2011-02-12 |
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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.