MRS. AMY HENDRICK MATISTIC (NPI# 1912189879) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912189879 |
| Entity Type | Individual |
| Full Name | MRS. AMY HENDRICK MATISTIC |
| Credential | RPH |
| Practice Address |
1755 Highway 34 East Suite 1400 Newnan GA 30265 |
| Practice Telephone | 7102527500 |
| Practice Fax Number | 7702543652 |
| Mailing Telephone | 7102527500 |
| Mailing Fax Number | 7702543652 |
| Enumeration Date | 2007-12-03 |
| Last Update Date | 2007-12-03 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 183500000X | Pharmacist | RPH017242 | GA | Pharmacy Service Providers |
| Street Address |
1755 HIGHWAY 34 EAST SUITE 1400 |
| City | NEWNAN |
| State | GA |
| Zip Code | 30265 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265041537 | Shiva Bazargan | Pharmacist | 3116 Sr 34 West, Newnan, GA 30265 | 2020-07-23 |
| 1992322549 | Doctorsbeyond Inc. | Clinic/Center | 277 Skyview Court, Newnan, GA 30265 | 2020-06-30 |
| 1225652936 | Jerrica Conyers | Nurse Practitioner | 1635 Highwat 34 East Suite C, Newnan, GA 30265 | 2020-05-29 |
| 1982234688 | Morgan Elizabeth Bross | Physician Assistant | 1825 Ga- 34, Newnan, GA 30265 | 2020-01-22 |
| 1013553379 | Hopebridge LLC | Behavior Technician | 2147 Newnan Crossing Boulevard East, Newnan, GA 30265 | 2019-11-21 |
| 1518528116 | Stepping Stones Psychiatric Care LLC | Nurse Practitioner | 3025 Sharpsburg Mccullum Rd, Building B Suite 103, Newnan, GA 30265 | 2019-06-25 |
| 1356823363 | Stephen William Jacon | Specialist/Technologist | 29 Muirfield Court, Newnan, GA 30265 | 2018-09-05 |
| 1881176832 | Blueprint Psychiatry, LLC | Psychiatry & Neurology | 1601 Highway 34 E Ste A, Newnan, GA 30265 | 2018-09-05 |
| 1548790769 | Timothy Collins | Physical Therapist | 1755 Ga-34, Suite 1300, Rehab Department, Newnan, GA 30265 | 2017-06-20 |
| 1497289748 | Edible Health & Wellness,llc | Clinic/Center | 90f Glenda Trace Pmb 318, Newnan, GA 30265 | 2017-04-13 |
| Find all providers in zip 30265 | ||||
| Taxonomy Code | 183500000X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care. |
| Notes: Source: Adapted from National Association of Boards of Pharmacy Model State Pharmacy Act, Article 1, Section 104. [1/1/2006: definition modified, source modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063013613 | John Ellis Iv | Pharmacist | 135 Rudders Xing, Newnan, GA 30263-7032 | 2020-11-02 |
| 1265041537 | Shiva Bazargan | Pharmacist | 3116 Sr 34 West, Newnan, GA 30265 | 2020-07-23 |
| 1588162580 | James W Duke Jr. | Pharmacist | 90f Glenda Trce Ste 321, Newnan, GA 30265-3858 | 2018-01-25 |
| 1205212206 | Anna Riley | Pharmacist | 3055 Highway 34 East, Newnan, GA 30265 | 2015-08-03 |
| 1003157744 | Michael A Chavez | Pharmacist | 310 Windermere Cir, Newnan, GA 30265-2279 | 2013-03-05 |
| 1831487099 | Rosette Duruh | Pharmacist | 1 Millard Farmer Ind Blvd, Newnan, GA 30263-1078 | 2011-07-20 |
| 1306144662 | Angeline Hyatt Harris | Pharmacist | 3055 Highway 34 E, Newnan, GA 30265-2179 | 2011-03-09 |
| 1629376215 | Donald Armond Nadreau Jr. | Pharmacist | 165 Tillinghast Trce, Newnan, GA 30265-6000 | 2011-03-04 |
| 1265683684 | Jere Douglas Couch | Pharmacist | 155 Portico Pl, Newnan, GA 30265-5947 | 2008-10-03 |
| 1063684397 | Jerome Krupa | Pharmacist | 741 White Oak Dr, Newnan, GA 30265-2056 | 2008-03-27 |
| Find all providers in NEWNAN | ||||
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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.