DR. JACOB EICHENBERGER (NPI# 1902192966) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1902192966 |
Entity Type | Individual |
Full Name | DR. JACOB EICHENBERGER |
Credential | M.D. |
Practice Address |
1120 15th Street Augusta GA 30912-0004 |
Mailing Address |
1499 Walton Way Suite 1400 Augusta GA 30901-2602 |
Practice Telephone | 7067246100 |
Mailing Telephone | 7067246100 |
Enumeration Date | 2011-06-28 |
Last Update Date | 2015-11-17 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 208000000X | Pediatrics | 074002 | GA | Allopathic & Osteopathic Physicians |
N | 208000000X | Pediatrics | MD51295 | TN | Allopathic & Osteopathic Physicians |
N | 208000000X | Pediatrics | 5030 | GA | Allopathic & Osteopathic Physicians |
Street Address |
1120 15TH STREET |
City | AUGUSTA |
State | GA |
Zip Code | 30912-0004 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1447237375 | Ricardo Azziz | Obstetrics & Gynecology | 1120 15th Street, Augusta, GA 30912-0004 | 2005-12-30 |
1174094668 | Mary Gabrielle Helfgott | Advanced Practice Midwife | 1120 15th Street, Ba #7513, Augusta, GA 30912 | 2018-12-10 |
1912492471 | Sarah Crumley Asmann | Nurse Practitioner | 1120 15th Street, Department of Surgery, Augusta, GA 30912 | 2018-06-27 |
1912499286 | Jillian Marie Soto | Family Medicine | 1120 15th Street, Augusta, GA 30912 | 2018-06-03 |
1447740741 | Amanda Meredith Saxon | Nurse Practitioner | 1120 15th Street, Bbr 6518, Augusta, GA 30912 | 2018-05-14 |
1447757968 | Mohamed M Meghil | Student in an Organized Health Care Education/Training Program | 1120 15th Street, Gc-1337, Augusta, GA 30912 | 2018-04-11 |
1942721667 | Christopher Glen Jackson | Emergency Medicine | 1120 15th Street, Augusta, GA 30912 | 2017-07-03 |
1063933000 | Andrea Martinez-velez | Anesthesiology | 1120 15th Street, Augusta, GA 30912 | 2017-06-29 |
1063941409 | Viviam Skarleth Trejo | Surgery | 1120 15th Street, Augusta, GA 30912 | 2017-06-08 |
1548799976 | Alexander Herzog | Internal Medicine | 1120 15th Street, Augusta, GA 30912 | 2017-06-08 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1548885940 | Hannah Gullickson Folsom | Family Medicine | 1459 Laney Walker Blvd Ae 3042, Augusta, GA 30912 | 2020-06-11 |
1487278909 | Robert Kennedy | Internal Medicine | Augusta University Internal Medicine Residency Program, 1120 15th Street, Bi 5070, Augusta, GA 30912 | 2020-06-01 |
1952968737 | Kayla M. Lasota | Pediatrics | 11230 115th St Ae3042, Augusta, GA 30912 | 2019-05-28 |
1003379280 | Kayla Cox | Internal Medicine | 1120 15th St Bi5070, Augusta, GA 30912 | 2019-04-13 |
1619435740 | Justin Ray Mackert | Student in an Organized Health Care Education/Training Program | Augusta University, 1120 15th Street, Gc 5110, Augusta, GA 30912 | 2019-03-07 |
1417444167 | Victor Celis | Dentist | John Wesley Gilbert Dr, Augusta, GA 30912 | 2018-04-18 |
1487157921 | Julie Ann Matsen | Student in an Organized Health Care Education/Training Program | 997 St. Sebastian Way, Eg-2021-10, Augusta Univ., Dept. of Psychiatry & Health Behavior, Augusta, GA 30912 | 2018-03-12 |
1497287031 | Luke Yuung-jier Chang | Ophthalmology | 1120 15th St # Ba2720, Augusta, GA 30912 | 2017-04-02 |
1821537622 | Lashawn Kay Boone | Nurse Practitioner | 1445 Harper St, Augusta, GA 30912 | 2017-02-14 |
1134675564 | Arnab Saha | Internal Medicine | 1120 15 Th St., Augusta, GA 30912 | 2016-08-26 |
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Taxonomy Code | 208000000X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Pediatrics |
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1134745953 | Molly C Shields | Pediatrics | Dugas Building Bg 107 1120 15th Street, Augusta, GA 30912-0001 | 2020-06-17 |
1033734918 | Lauren Wooten Smith | Pediatrics | Chog Pediatric Residency Program 1120 15th Street, Augusta, GA 30912-0001 | 2020-06-16 |
1487211199 | Ashley Elizabeth Miller | Pediatrics | 1146 Harper Street, Augusta, GA 30912-0001 | 2019-05-29 |
1952968737 | Kayla M. Lasota | Pediatrics | 11230 115th St Ae3042, Augusta, GA 30912 | 2019-05-28 |
1558824797 | John-david Constantine Bruce | Pediatrics | Dugas Building (bg-1071) 1120 15th Street, Augusta, GA 30912-0001 | 2019-04-12 |
1306229182 | Alexander James Eason | Pediatrics | Georgia Regents Medical Ctr, 1120 15th Street, Augusta, GA 30912-0001 | 2015-06-30 |
1184945339 | Shannon Nicole Myers | Pediatrics | 3727 Executive Center Dr, Augusta, GA 30907-2398 | 2010-06-22 |
1801113386 | Gerard Rubin | Pediatrics | 6 E Chestnut St Ste 310, Augusta, ME 04330-5717 | 2010-04-23 |
1013246487 | William Weston IIi | Pediatrics | 93 Bristlecone Ct., Augusta, GA 30909-1861 | 2009-12-15 |
1225285372 | Mustafa Musa Nimir | Pediatrics | 1120 15th St Ae-3042, Medical College of Georgia, Augusta, GA 30912-5000 | 2008-08-20 |
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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.