Traditions Health | |
126 S Access Rd Chula GA 31733-4204 | |
(229) 520-3052 | |
(229) 520-3062 |
Full Name | Traditions Health |
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Speciality | Clinic/Center |
Location | 126 S Access Rd, Chula, 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 |
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Traditions Health 6840 Carothers Pkwy Ste 550 Franklin TN 37067-8002 Ph: (979) 704-6547 | Traditions Health 126 S Access Rd Chula GA 31733-4204 Ph: (229) 520-3052 |
NPI Number | 1811635253 |
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Provider Enumeration Date | 05/25/2022 |
Last Update Date | 06/21/2024 |
Medicare PECOS PAC ID | 8022372549 |
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Medicare Enrollment ID | O20220722002642 |
Identifier | Type | State | Issuer |
---|---|---|---|
1811635253 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261Q00000X | Clinic/center | (* (Not Available)) | Primary |
Provider Name | Anthony G Captain |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1023035094 PECOS PAC ID: 0749259661 Enrollment ID: I20050228000463 |
Provider Name | Ayman Rihawi |
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Provider Type | Practitioner - Infectious Disease |
Provider Identifiers | NPI Number: 1326097387 PECOS PAC ID: 8426004375 Enrollment ID: I20050324000082 |
Provider Name | Carl Johnson |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1023018561 PECOS PAC ID: 4688869704 Enrollment ID: I20101115000206 |
Provider Name | Christina Renee Kopsick |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1629618806 PECOS PAC ID: 0345679494 Enrollment ID: I20200410002253 |
Provider Name | Sabrina D Griffin |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1083258776 PECOS PAC ID: 8022435742 Enrollment ID: I20200826002500 |
Provider Name | Shawna K Cribb |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1124780721 PECOS PAC ID: 3476945866 Enrollment ID: I20220114001044 |