| Gomed, Llc | |
|
2011 Commerce Dr N Ste 25 Peachtree City GA 30269-3538 | |
| (844) 994-6633 | |
| (770) 463-5177 |
| Full Name | Gomed, Llc |
|---|---|
| Speciality | General Practice |
| Location | 2011 Commerce Dr N Ste 25, Peachtree City, Georgia |
| Authorized Official Name and Position | Christopher Allen Pitts (CEO/FOUNDING PARTNER) |
| Authorized Official Contact | 9125363784 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Gomed, Llc 2011 Commerce Dr N Peachtree City GA 30269-3538 Ph: (844) 994-6633 | Gomed, Llc 2011 Commerce Dr N Ste 25 Peachtree City GA 30269-3538 Ph: (844) 994-6633 |
| NPI Number | 1053706531 |
|---|---|
| Provider Enumeration Date | 04/01/2015 |
| Last Update Date | 05/07/2024 |
| Medicare PECOS PAC ID | 9537425533 |
|---|---|
| Medicare Enrollment ID | O20171107003590 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053706531 | NPI | - | NPPES |
| 11D2139998 | Other | GA | CLIA WAIVER CERTIFICATION |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (Georgia) | Primary |
| Provider Name | Jamie W Walraven |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1750328738 PECOS PAC ID: 0446217285 Enrollment ID: I20041214000478 |
| Provider Name | Christopher A Edens |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1194762625 PECOS PAC ID: 1456302389 Enrollment ID: I20050208000441 |
| Provider Name | Wanda E Guy-craft |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1598958894 PECOS PAC ID: 5092846113 Enrollment ID: I20100706000134 |
| Provider Name | Chionesu Kwesi Sonyika |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1073633657 PECOS PAC ID: 0042390247 Enrollment ID: I20100719000680 |
| Provider Name | Wasiu F Adisa |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1962602599 PECOS PAC ID: 6800050329 Enrollment ID: I20120614000044 |
| Provider Name | Angela R Parker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386155612 PECOS PAC ID: 8921365602 Enrollment ID: I20171205002604 |
| Provider Name | Lisa Caiafa |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144719485 PECOS PAC ID: 3072863265 Enrollment ID: I20180910001896 |
| Provider Name | Dawnne R Harbin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326696568 PECOS PAC ID: 2466884275 Enrollment ID: I20191118000213 |
| Provider Name | Penelope Anderson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306436993 PECOS PAC ID: 9739595307 Enrollment ID: I20210305000136 |
| Provider Name | Elizabeth Rainey Brown |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952973547 PECOS PAC ID: 8921496647 Enrollment ID: I20211029002390 |
| Provider Name | C.jennifer Ashley Metzger |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982339891 PECOS PAC ID: 7416332713 Enrollment ID: I20220922003501 |
| Provider Name | Eric Fusan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669185559 PECOS PAC ID: 3072984186 Enrollment ID: I20230308000137 |
| Provider Name | Daniel William Fisher |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1457670358 PECOS PAC ID: 8820252851 Enrollment ID: I20230414000238 |
| Provider Name | Robert Mester |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1366604415 PECOS PAC ID: 3274794227 Enrollment ID: I20230901002621 |
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