| Traditions Health | |
|
4210 Columbia Rd Building 12, Suite D Augusta GA 30907-4047 | |
| (706) 396-5600 | |
| (706) 396-5605 |
| Full Name | Traditions Health |
|---|---|
| Speciality | Clinic/Center |
| Location | 4210 Columbia Rd, Augusta, Georgia |
| Authorized Official Name and Position | John Kerndl (CFO & SECRETARY) |
| Authorized Official Contact | 9797046547 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Traditions Health 6840 Carothers Pkwy Ste 550 Franklin TN 37067-8002 Ph: (979) 704-6547 | Traditions Health 4210 Columbia Rd Building 12, Suite D Augusta GA 30907-4047 Ph: (706) 396-5600 |
| NPI Number | 1962140392 |
|---|---|
| Provider Enumeration Date | 05/25/2022 |
| Last Update Date | 06/24/2024 |
| Medicare PECOS PAC ID | 2264676113 |
|---|---|
| Medicare Enrollment ID | O20220711000683 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962140392 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| Provider Name | Anthony G Captain |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1023035094 PECOS PAC ID: 0749259661 Enrollment ID: I20050228000463 |
| Provider Name | David B Hogue |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1538174933 PECOS PAC ID: 8527017607 Enrollment ID: I20100122000338 |
| Provider Name | Frederick A Merrill |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1740299650 PECOS PAC ID: 9537118617 Enrollment ID: I20100125000597 |
| Provider Name | Georg Laemmerhirt |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1851586747 PECOS PAC ID: 9032263926 Enrollment ID: I20120620000479 |
| Provider Name | Blanche L. Kearley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871978148 PECOS PAC ID: 8527357870 Enrollment ID: I20160510001814 |
| Provider Name | Amethyst Wilder |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1396168753 PECOS PAC ID: 3072861764 Enrollment ID: I20180813002860 |
| Provider Name | Amy L Lewis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851069470 PECOS PAC ID: 2163814666 Enrollment ID: I20220112002928 |
| Provider Name | Kytrena Harris |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427600469 PECOS PAC ID: 0840657060 Enrollment ID: I20230602002176 |
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