CANDICE NEWTON WILSON (NPI# 1902304439) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1902304439 |
Entity Type | Individual |
Full Name | CANDICE NEWTON WILSON |
Credential | PT |
Practice Address |
3708 Northside Dr Macon GA 31210-2404 |
Mailing Address |
Po Box 6317 Macon GA 31208-6317 |
Practice Telephone | 4787454206 |
Enumeration Date | 2018-01-30 |
Last Update Date | 2019-06-11 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 2251X0800X |
Physical Therapist Specialization: Orthopedic |
PT007137 | GA | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
GA | 300022345A | 05 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1609314061 | Candice Melody Wilson | Nurse Practitioner | 1186 Cypress Glen Cir, Kissimmee, FL 34741-7560 | 2017-02-06 |
1902282478 | Candice Wilson | Occupational Therapy Assistant | 82824 Crawford Dr, Indio, CA 92201-7491 | 2015-08-06 |
1396379004 | Candice L Wilson | Counselor | 11057 Turfgrass Way, Indianapolis, IN 46236-8320 | 2020-03-03 |
1326257189 | Candice Lynn Wilson | Speech-Language Pathologist | 97 Preston Rd, Griswold, CT 06351-2516 | 2007-05-21 |
1508086935 | Candice Wilson | Counselor | 900 Shugart Rd, Dalton, GA 30720 | 2007-04-26 |
1215997028 | Candice Lynn Wilson | Specialist | 990 Oak Ridge Tpke, Oak Ridge, TN 37830-6976 | 2006-03-24 |
Street Address |
3708 NORTHSIDE DR |
City | MACON |
State | GA |
Zip Code | 31210-2404 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1245236744 | Edward Keith Grant | Physician Assistant | 3708 Northside Dr, Macon, GA 31210-2404 | 2005-06-21 |
1295333680 | Daniel Braschler | Physical Therapist | 3708 Northside Dr, Macon, GA 31210-2404 | 2020-10-16 |
1881203958 | Bobby Holcumb IIi | Physical Therapy Assistant | 3708 Northside Dr, Macon, GA 31210-2404 | 2020-07-24 |
1184240426 | Jenna Walton | Nurse Practitioner | 3708 Northside Dr, Macon, GA 31210-2404 | 2020-06-23 |
1710525886 | April Hancock | Physical Therapist | 3708 Northside Dr, Macon, GA 31210-2404 | 2019-12-19 |
1942856620 | Natalia Busuttil | Physical Therapist | 3708 Northside Dr, Macon, GA 31210-2404 | 2019-08-17 |
1689228918 | Cameron Tidwell | Nurse Practitioner | 3708 Northside Dr, Macon, GA 31210-2404 | 2019-07-25 |
1255892600 | Joshua Beagle | Physical Therapist | 3708 Northside Dr, Macon, GA 31210-2404 | 2019-03-28 |
1629536776 | Mayur Vishnubhai Patel | Physical Therapist | 3708 Northside Dr, Macon, GA 31210-2404 | 2019-03-07 |
1043776891 | Lauren Clark | Nurse Practitioner | 3708 Northside Dr, Macon, GA 31210-2404 | 2019-02-18 |
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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 |
Find all providers in zip 31210 |
Taxonomy Code | 2251X0800X |
Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Classification | Physical Therapist |
Specialization | Orthopedic |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1477512903 | Pam Thomasson | Physical Therapist | 1600 Forsyth St, Macon, GA 31201-1408 | 2006-03-22 |
1255892600 | Joshua Beagle | Physical Therapist | 3708 Northside Dr, Macon, GA 31210-2404 | 2019-03-28 |
1629536776 | Mayur Vishnubhai Patel | Physical Therapist | 3708 Northside Dr, Macon, GA 31210-2404 | 2019-03-07 |
1033634811 | Lauren Coleman | Physical Therapist | 3708 Northside Dr, Macon, GA 31210-2404 | 2017-08-14 |
1518319409 | Stephanie Reich Kauzlarich | Physical Therapist | 3708 Northside Dr, Macon, GA 31210-2404 | 2016-07-05 |
1790136836 | Randall Clay Cannon | Physical Therapist | 3708 Northside Dr, Macon, GA 31210-2404 | 2016-06-30 |
1235371295 | Fce-ppd Center | Physical Therapist | 3040 Riverside Dr, Suite C-5, Macon, GA 31210-2521 | 2009-04-06 |
1790745529 | Catherine L Hawkins | Physical Therapist | 1600 Forsyth St, Macon, GA 31201-1408 | 2006-03-24 |
1154381960 | John T Williamson | Physical Therapist | 1600 Forsyth St, Macon, GA 31201-1408 | 2006-03-24 |
1861452682 | Katharine E Nelson | Physical Therapist | 1600 Forsyth St, Macon, GA 31201-1408 | 2006-03-24 |
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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.