DR. JACK R EADES (NPI# 1992890727) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1992890727 |
| Entity Type | Individual |
| Full Name | DR. JACK R EADES |
| Credential | MD |
| Practice Address |
5223 Paulsen St Savannah GA 31405 |
| Practice Telephone | 9123039355 |
| Practice Fax Number | 9123039356 |
| Mailing Telephone | 9123039355 |
| Mailing Fax Number | 9123039356 |
| Enumeration Date | 2006-10-04 |
| Last Update Date | 2014-02-10 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207K00000X | Allergy & Immunology | 20053 | SC | Allopathic & Osteopathic Physicians |
| Y | 207K00000X | Allergy & Immunology | 043360 | GA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 00751264F | 05 | |
| SC | G43360 | 05 | |
| GA | 00751264D | 05 | |
| GA | 00751264E | 05 |
| Street Address |
5223 PAULSEN ST |
| City | SAVANNAH |
| State | GA |
| Zip Code | 31405 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942771266 | Punam Sheth | Nurse Practitioner | 5223 Paulsen St, Savannah, GA 31405-4700 | 2018-12-14 |
| 1306330030 | Liza Bashambu | Physician Assistant | 5223 Paulsen St, Savannah, GA 31405-4700 | 2018-06-16 |
| 1467547281 | Southern Allergy and Asthma PC | Allergy & Immunology | 5223 Paulsen St, Savannah, GA 31405 | 2006-10-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053918441 | Nicole Marie Tetro | Anesthesiology | Candler Hospital, 5353 Reynolds St, Savannah, GA 31405 | 2020-10-08 |
| 1154983880 | Nickes Medical Supply, LLC. | Durable Medical Equipment & Medical Supplies | 6020 Halsey St, Savannah, GA 31405 | 2019-07-02 |
| 1215593025 | Lee Ann Ryle | Nurse Practitioner | 5223 Paulsen St., Savannah, GA 31405 | 2019-05-16 |
| 1942765334 | Raegan Epps | Behavior Technician | 613 Stephenson Ave Ste 205, Savannah, GA 31405 | 2019-02-10 |
| 1679050454 | Phenomenal Nursing Service | Registered Nurse | 604 South St., 604 South St, Savannah, GA 31405 | 2018-07-24 |
| 1275029472 | Chelsea Amanda Keedy | Pharmacist | 836 E. 65th St., Medical Arts #4, Savannah, GA 31405 | 2018-07-11 |
| 1265933840 | Dwc-p LLC | Dentist | 5209 Paulsen Street, Savannah, GA 31405 | 2018-02-28 |
| 1386153005 | Aaron Shaw | Hearing Instrument Specialist | 5501 Abercorn St Ste E, Savannah, GA 31405 | 2017-09-26 |
| 1063946028 | Elizabeth Bentley Bruhn-danello | Dietitian, Registered | 836 East 65th Street, Medical Arts #4, Savannah, GA 31405 | 2017-04-17 |
| 1396278230 | Theresa Lynn George | Health Educator | 836 East 65 Th Street, Medical Arts #4, Savannah, GA 31405 | 2017-04-07 |
| Find all providers in zip 31405 | ||||
| Taxonomy Code | 207K00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Allergy & Immunology |
| An allergist-immunologist is trained in evaluation, physical and laboratory diagnosis, and management of disorders involving the immune system. Selected examples of such conditions include asthma, anaphylaxis, rhinitis, eczema, and adverse reactions to drugs, foods, and insect stings as well as immune deficiency diseases (both acquired and congenital), defects in host defense, and problems related to autoimmune disease, organ transplantation, or malignancies of the immune system. |
| Notes: Source: American Board of Medical Specialties, 2007, www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Allergy and Immunology, 2007. http://www.abai.org/ No subspecialty certificates in allergy and immunology are offered by the American Board of Allergy and Immunology (ABAI). The ABAI, however, does offer formal special pathways for physicians seeking dual certification in allergy/immunology and pediatric pulmonology; allergy/immunology and pediatric rheumatology; and allergy/immunology and adult rheumatology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467547281 | Southern Allergy and Asthma PC | Allergy & Immunology | 5223 Paulsen St, Savannah, GA 31405 | 2006-10-04 |
| 1992742845 | Coastal Allergy & Asthma PC | Allergy & Immunology | 505 Eisenhower Dr, Savannah, GA 31406-2668 | 2006-06-01 |
| 1407816432 | Brad Henry Goodman | Allergy & Immunology | 505 Eisenhower Dr, Savannah, GA 31406-2668 | 2006-03-24 |
| 1255390829 | Monica Rama Kenney | Allergy & Immunology | 505 Eisenhower Dr, Savannah, GA 31406-2668 | 2006-03-21 |
| 1972562668 | Bruce Daniel Finkel | Allergy & Immunology | 505 Eisenhower Dr, Savannah, GA 31406-2668 | 2006-03-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053935411 | St. Mary's Medical Group, Inc. | Allergy & Immunology | 1360 Caduceus Way Bldg 200-102, Watkinsville, GA 30677-7349 | 2020-06-02 |
| 1750902185 | Center for Allergy and Asthma Southern Crescent | Allergy & Immunology | 1975 Highway 54 W Ste 255, Peachtree City, GA 30269-4794 | 2020-04-27 |
| 1003472036 | Annual Wellness Centers of America | Allergy & Immunology | 753 Old Norcross Rd Ste B, Lawrenceville, GA 30046-4312 | 2019-05-15 |
| 1821567371 | Breathe Better Allergy Asthma & Sinus Center, Inc | Allergy & Immunology | 950 S Enota Dr Ne Ste A, Gainesville, GA 30501-2439 | 2018-11-14 |
| 1982111316 | Sofia Miriam Sheikh | Allergy & Immunology | 4003 Oak Forest Dr Ne, Marietta, GA 30062-8022 | 2018-01-08 |
| 1366969560 | Allergy Consulting Group, LLC | Allergy & Immunology | 5752b Buford Hwy Ne, Doraville, GA 30340-1207 | 2017-08-28 |
| 1235684192 | Heather Raborn | Allergy & Immunology | 1350 Walton Way Ste 5100, Augusta, GA 30901 | 2016-08-22 |
| 1730597196 | Allergy Testing Solutions, LLC | Allergy & Immunology | 789 Hammond Dr, Unit 2510, Sandy Springs, GA 30328-8161 | 2014-07-30 |
| 1164863999 | Chih-yin Yeh | Allergy & Immunology | 5673 Peachtree Dunwoody Rd # 445, Atlanta, GA 30342-1731 | 2013-07-09 |
| 1023352069 | Advanced Allergy Inc | Allergy & Immunology | 5512 Glenridge Dr Ne, Unit A, Atlanta, GA 30342-7213 | 2012-11-15 |
| Find all providers with the same taxonomy | ||||
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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.