| Traditions Health | |
|
100 Market Place Blvd Ste 301 Cartersville GA 30121-8717 | |
| (678) 290-4817 | |
| (678) 290-4821 |
| Full Name | Traditions Health |
|---|---|
| Speciality | Clinic/Center |
| Location | 100 Market Place Blvd Ste 301, Cartersville, 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 100 Market Place Blvd Ste 301 Cartersville GA 30121-8717 Ph: (678) 290-4817 |
| NPI Number | 1538807953 |
|---|---|
| Provider Enumeration Date | 05/25/2022 |
| Last Update Date | 06/28/2024 |
| Medicare PECOS PAC ID | 3476682659 |
|---|---|
| Medicare Enrollment ID | O20220824000608 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538807953 | 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 | Kathalina V Lacoste |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255459335 PECOS PAC ID: 9335182211 Enrollment ID: I20050602000553 |
| Provider Name | Casmir Uzoma Nwigwe |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1306029293 PECOS PAC ID: 5597835934 Enrollment ID: I20080528000501 |
| Provider Name | Saurabh Desai |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1578626602 PECOS PAC ID: 7214032689 Enrollment ID: I20100916001177 |
| Provider Name | Thomas John Demarco |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1093825846 PECOS PAC ID: 3971555129 Enrollment ID: I20110223000959 |
| Provider Name | Lakshman K Dinavahi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1528233723 PECOS PAC ID: 5799836243 Enrollment ID: I20130820000875 |
| Provider Name | Catherine N Kiarie |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548692270 PECOS PAC ID: 7012151491 Enrollment ID: I20130925000545 |
| Provider Name | Mya Williams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831638006 PECOS PAC ID: 1951678010 Enrollment ID: I20170522002058 |
| Provider Name | Latoya Ann Simon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790203552 PECOS PAC ID: 5496011520 Enrollment ID: I20171106003230 |
| Provider Name | Suzette A Whilby |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194361782 PECOS PAC ID: 9234556945 Enrollment ID: I20200826002372 |
| Provider Name | Heather M. Mclaughlin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861032187 PECOS PAC ID: 2062840812 Enrollment ID: I20210726002596 |
| Provider Name | Patricia E Weaver |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629645544 PECOS PAC ID: 6204233695 Enrollment ID: I20210928001937 |
| Provider Name | Eldine Garraud |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992589691 PECOS PAC ID: 1759727837 Enrollment ID: I20240312000425 |
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