| Restor Diabetes Care Llc | |
|
300 Parkbrooke Pl Ste 150 Woodstock GA 30189-7280 | |
| (706) 395-6451 | |
| Not Available |
| Full Name | Restor Diabetes Care Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 300 Parkbrooke Pl Ste 150, Woodstock, Georgia |
| Authorized Official Name and Position | Melissa Hood (REVENUE CYCLE MANAGER) |
| Authorized Official Contact | 9125902184 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Restor Diabetes Care Llc 394 S Milledge Ave Ste 101 Athens GA 30605-5626 Ph: (706) 395-6451 | Restor Diabetes Care Llc 300 Parkbrooke Pl Ste 150 Woodstock GA 30189-7280 Ph: (706) 395-6451 |
| NPI Number | 1992433882 |
|---|---|
| Provider Enumeration Date | 08/10/2022 |
| Last Update Date | 01/17/2024 |
| Medicare PECOS PAC ID | 7911362363 |
|---|---|
| Medicare Enrollment ID | O20230508002144 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992433882 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| Provider Name | Matthew Stephen Farmer |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1316233323 PECOS PAC ID: 1153543673 Enrollment ID: I20141117000203 |
| Provider Name | Heather Nicole Pickelsimer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619336005 PECOS PAC ID: 4486944212 Enrollment ID: I20160608002601 |
| Provider Name | Christopher Lepage Gaunder |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1811133101 PECOS PAC ID: 8628353042 Enrollment ID: I20190508000626 |
| Provider Name | Kelsey Berkner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730725276 PECOS PAC ID: 2365877123 Enrollment ID: I20200124000996 |
| Provider Name | Chandler Marie Davis |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1922763234 PECOS PAC ID: 1658760699 Enrollment ID: I20211115000315 |
| Provider Name | Scott Allen Bickerton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104482322 PECOS PAC ID: 0244616027 Enrollment ID: I20220930002670 |
| Provider Name | Natasha L Osborne |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730665118 PECOS PAC ID: 1254796774 Enrollment ID: I20230504002314 |
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