TAYLOR JADE PENCE (NPI# 1790231363) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790231363 |
| Entity Type | Individual |
| Full Name | TAYLOR JADE PENCE |
| Credential | CAA |
| Practice Address |
304 Turner Mccall Blvd Sw Rome GA 30165-5621 |
| Mailing Address |
76 Shady Ct La Fayette GA 30728-6277 |
| Practice Telephone | 7065095000 |
| Mailing Telephone | 4238830330 |
| Enumeration Date | 2016-09-01 |
| Last Update Date | 2016-09-01 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 367H00000X | Anesthesiologist Assistant | GA | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376032961 | Taylor Showalter Pence | Student in an Organized Health Care Education/Training Program | 1250 E Marshall St # 980509, Richmond, VA 23298-5051 | 2018-05-09 |
| Street Address |
304 TURNER MCCALL BLVD SW |
| City | ROME |
| State | GA |
| Zip Code | 30165-5621 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477501047 | Sonya R Collins | Pediatrics | 304 Turner Mccall Blvd Sw, Rome, GA 30165-5621 | 2006-05-05 |
| 1316546013 | Forrest Baker Simpson | Registered Nurse | 304 Turner Mccall Blvd Sw, Rome, GA 30165-5621 | 2020-10-22 |
| 1093324477 | Maggie Brewer | Occupational Therapist | 304 Turner Mccall Blvd Sw, Rome, GA 30165-5621 | 2020-07-30 |
| 1225646458 | Carril Safia Alexander | Nurse Practitioner | 304 Turner Mccall Blvd Sw, Rome, GA 30165-5621 | 2020-07-14 |
| 1164049656 | Kim Carlos Farmer | Nurse Practitioner | 304 Turner Mccall Blvd Sw, Rome, GA 30165-5621 | 2020-06-30 |
| 1497370506 | Nathan Henry | Student in an Organized Health Care Education/Training Program | 304 Turner Mccall Blvd Sw, Rome, GA 30165-5621 | 2020-06-15 |
| 1124643291 | Gokhan Emre Taskale | Student in an Organized Health Care Education/Training Program | 304 Turner Mccall Blvd Sw, Rome, GA 30165-5621 | 2020-06-14 |
| 1962027037 | Adriana Delmonico | Student in an Organized Health Care Education/Training Program | 304 Turner Mccall Blvd Sw, Rome, GA 30165-5621 | 2020-06-14 |
| 1295350494 | Edward Lawson Held | Student in an Organized Health Care Education/Training Program | 304 Turner Mccall Blvd Sw, Rome, GA 30165-5621 | 2020-06-12 |
| 1740805951 | Yassmin Shariff | Student in an Organized Health Care Education/Training Program | 304 Turner Mccall Blvd Sw, Rome, GA 30165-5621 | 2020-06-12 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346868775 | Heather Bowman | Physical Therapist | 600 Eagle, E Lake Dr, Rome, GA 30165 | 2020-07-13 |
| 1205451101 | Kristopher Nelson | Student in an Organized Health Care Education/Training Program | 4256, 304 Shorter Ave Nw #201, Rome, GA 30165 | 2020-06-16 |
| 1962061457 | Stuart Paul Shaklee | Occupational Therapy Assistant | 1356 Redmond Road, Rome, GA 30165 | 2019-06-10 |
| 1386001055 | Autumn Streetman | Counselor | 6 Mathis Drive, Rome, GA 30165 | 2016-01-26 |
| 1144695784 | Gabrador Milligan | Counselor | 6 Mathis Road, Rome, GA 30165 | 2015-12-08 |
| 1386041952 | Theresa Suits | Registered Nurse | 1 Woodbine Avenue, Rome, GA 30165 | 2014-11-26 |
| 1942561147 | Nicole C. Christian | Clinical Neuropsychologist | 305 Redmond Rd, Rome, GA 30165 | 2012-06-04 |
| 1679832711 | Niki Pareshkumar Bhavsar | Internal Medicine | 3041 Turner Mccall Blvd, Rome, GA 30165 | 2012-05-10 |
| 1285927491 | Amanda Fischer Reeves | Family Medicine | 304 Shorter Ave Nw Ste 102, Rome, GA 30165 | 2011-05-20 |
| 1033436647 | Northland Hearing Centers, Inc. | Hearing Instrument Specialist | 4 Coosawattee Ave, Rome, GA 30165 | 2010-04-23 |
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| Taxonomy Code | 367H00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Anesthesiologist Assistant |
| An individual certified by the state to perform anesthesia services under the direct supervision of an anesthesiologist. Anesthesiologist Assistants are required to have a bachelor's degree with a premed curriculum prior to entering a two-year anesthesiology assistant program, which is focused upon the delivery and maintenance of anesthesia care as well as advanced patient monitoring techniques. An Anesthesiologist Assistant must work as a member of the anesthesia care team under the direction of a qualified Anesthesiologist. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700447604 | Rebecca Anne Phrommala | Anesthesiologist Assistant | 501 Redmond Rd Nw, Rome, GA 30165-1415 | 2019-06-22 |
| 1457833105 | Harry Mallette Peagler Iv | Anesthesiologist Assistant | 304 Turner Mccall Blvd Sw, Rome, GA 30165-5621 | 2018-08-29 |
| 1982181046 | Kay Ellen Winfrey | Anesthesiologist Assistant | 304 Turner Mccall Blvd Sw, Rome, GA 30165-5621 | 2018-07-22 |
| 1922585074 | Nery J Castillo | Anesthesiologist Assistant | 501 Redmond Rd Nw, Rome, GA 30165 | 2018-07-22 |
| 1407102304 | Lauriel Bortnick | Anesthesiologist Assistant | 501 Redmond Rd Nw, Rome, GA 30165-1415 | 2012-07-28 |
| 1730460437 | Lani Michelle Roberts | Anesthesiologist Assistant | 304 Turner Mccall Blvd Sw, Rome, GA 30165-5621 | 2011-09-08 |
| 1518111624 | Charles E. Hufstetler | Anesthesiologist Assistant | 501 Redmond Rd Nw, Rome, GA 30165-1415 | 2008-11-17 |
| 1861654089 | Sharna Charlotte Draia | Anesthesiologist Assistant | 501 Redmond Rd Nw, Rome, GA 30165-1415 | 2008-06-29 |
| 1295840585 | Jeffrey Lee Mahoney | Anesthesiologist Assistant | 501 Redmond Rd Nw, Rome, GA 30165-1415 | 2006-08-20 |
| 1134175680 | Douglas E Mcniece | Anesthesiologist Assistant | 501 Redmond Rd Nw, Anesthesiology Department, Rome, GA 30165-1415 | 2006-05-26 |
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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.