DR. GREGORY RUSIECKI (NPI# 1982229175) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1982229175 |
| Entity Type | Individual |
| Full Name | DR. GREGORY RUSIECKI |
| Credential | DO |
| Practice Address |
304 Turner Mccall Blvd Sw Rome GA 30165-5621 |
| Practice Telephone | 7065095000 |
| Enumeration Date | 2020-06-12 |
| Last Update Date | 2020-06-12 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | 12024 | GA | Student, Health Care |
| 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 | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205451101 | Kristopher Nelson | Student in an Organized Health Care Education/Training Program | 4256, 304 Shorter Ave Nw #201, Rome, GA 30165 | 2020-06-16 |
| 1659877579 | Jessica Judith White | Student in an Organized Health Care Education/Training Program | 101 Lovell Ln Sw, Rome, GA 30165-3631 | 2018-03-30 |
| 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 |
| 1568087708 | Nzota Pelagie Nsona Koyagialo | Student in an Organized Health Care Education/Training Program | 304 Shorter Ave Nw Ste 201, Rome, GA 30165-4256 | 2020-06-13 |
| 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 |
| 1932738127 | Anand Marangattu Parameswaran | Student in an Organized Health Care Education/Training Program | 501 Redmond Road, Rome, GA 30165 | 2020-04-08 |
| 1003445495 | Brice Peter Bowerman | Student in an Organized Health Care Education/Training Program | 501 Redmond Rd Nw, Rome, GA 30165-1415 | 2020-04-07 |
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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.