JONATHAN DAVID PEWITT (NPI# 1912198979) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912198979 |
| Entity Type | Individual |
| Full Name | JONATHAN DAVID PEWITT |
| Credential | M.D. |
| Practice Address |
550 Redmond Rd Nw Rome GA 30165-1416 |
| Mailing Address |
221 Technology Pkwy Nw Rome GA 30165-1369 |
| Practice Telephone | 7062338516 |
| Practice Fax Number | 7062338517 |
| Mailing Telephone | 7622351000 |
| Enumeration Date | 2007-08-06 |
| Last Update Date | 2020-04-28 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207N00000X | Dermatology | 065413 | GA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GU | 003108826A | 05 |
| Street Address |
550 REDMOND RD NW |
| City | ROME |
| State | GA |
| Zip Code | 30165-1416 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457346496 | Poonam Singh | Internal Medicine | 550 Redmond Rd Nw, Rome, GA 30165-1416 | 2005-09-15 |
| 1174158505 | Whitney Tolbert Albright | Nurse Practitioner | 550 Redmond Rd Nw, Rome, GA 30165-1416 | 2020-03-05 |
| 1457990020 | Kimberly Mae Evans | Nurse Practitioner | 550 Redmond Rd Nw, Rome, GA 30165-1416 | 2019-12-31 |
| 1710522933 | William Edward Johnson | Physician Assistant | 550 Redmond Rd Nw, Rome, GA 30165-1416 | 2019-11-12 |
| 1053876391 | Samantha Danielle Pruitt | Nurse Practitioner | 550 Redmond Rd Nw, Rome, GA 30165-1416 | 2019-01-31 |
| 1205311131 | Austin James Malcom | Physician Assistant | 550 Redmond Rd Nw, Rome, GA 30165-1416 | 2018-09-26 |
| 1972025955 | Tricia Lee Nelson | Nurse Practitioner | 550 Redmond Rd Nw, Rome, GA 30165-1416 | 2017-07-12 |
| 1417400318 | Inga Elita Bennett | Nurse Practitioner | 550 Redmond Rd Nw, Rome, GA 30165-1416 | 2016-07-27 |
| 1306298674 | Krishna Sumeer Tah | Physician Assistant | 550 Redmond Rd Nw, Rome, GA 30165-1416 | 2016-07-11 |
| 1467807750 | Robin Ann Hawkland | Nurse Practitioner | 550 Redmond Rd Nw, Rome, GA 30165-1416 | 2016-04-25 |
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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 |
| Find all providers in zip 30165 | ||||
| Taxonomy Code | 207N00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Dermatology, 2007. http://www.abderm.org/ Board certification is provided by the American Board of Dermatology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689735029 | Julia Griffin Girard | Dermatology | 550 Redmond Rd Nw, Rome, GA 30165-1416 | 2006-12-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720686058 | Worldwide Medical Healthcare Inc | Dermatology | 790 Church St Ne Ste 300, Marietta, GA 30060-8902 | 2020-10-09 |
| 1972142891 | Worldwide Medical Distributor, LLC | Dermatology | 3780 Old Norcross Rd Ste 103, Duluth, GA 30096-1762 | 2019-12-23 |
| 1932762218 | Laura Quinn Biehle | Dermatology | 5730 Glenridge Dr Ste T100, Atlanta, GA 30328-5747 | 2019-04-22 |
| 1003479254 | Kiley Katherine Fagan | Dermatology | 775 Aronson Lake Ct, Roswell, GA 30075-7172 | 2019-04-15 |
| 1346700127 | Gerald Chotiner | Dermatology | 2887 Gant Qtrs. Circle, Marietta, GA 30068-3719 | 2019-03-20 |
| 1205308616 | Belle Lumiere Cosmetics LLC | Dermatology | 753 Old Norcross Road, Lawrenceville, GA 30046 | 2018-12-24 |
| 1154890564 | Sidney Adele Brown-caggiano | Dermatology | 4645 Timber Ridge Dr Ste 100, Douglasville, GA 30135-7542 | 2018-11-14 |
| 1194209163 | Live Oak Dermatology | Dermatology | 135 Norcross St # 8, Roswell, GA 30075-3867 | 2018-09-17 |
| 1942780994 | Skyn Clinic & Apothecary | Dermatology | 1150 Peachtree Industrial Blvd Ste 165, Suwanee, GA 30024-1903 | 2018-08-20 |
| 1649750688 | Zola Nemorin | Dermatology | 1500 Peachtree Industrial Blvd Ste 165, Suwanee, GA 30024-8490 | 2018-08-20 |
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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.