Augusta Allergy and Asthma, LLC

Primary specialty

Allergy & Immunology PhysicianTaxonomy code 207K00000X

License

045041 Issued in GA

Legal business name

AUGUSTA ALLERGY AND ASTHMA, LLC

Practice address

4350 Towne Centre Dr Ste 1500
Evans, GA 30809-3332

Phone

(706) 421-1700

Fax

(706) 396-0618

NPI assigned

Jan 23, 2012

Last updated

Mar 5, 2024By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Tracie Broome

Title

Office Coordinator

Phone

(706) 421-1700

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Gena Marie Bonitatibus, M.D.

  • Allergy & Immunology Physician
  • Evans, GA
  • NPI 1184621310

  Single Specialty

  Medicare reassignment NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1327276800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1709596800000",
    "number": "1003187071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4350 TOWNE CENTRE DR STE 1500",
            "city": "EVANS",
            "state": "GA",
            "postal_code": "308093332",
            "telephone_number": "706-421-1700",
            "fax_number": "706-396-0618"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4350 TOWNE CENTRE DR STE 1500",
            "city": "EVANS",
            "state": "GA",
            "postal_code": "308093332",
            "telephone_number": "706-421-1700",
            "fax_number": "706-396-0618"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AUGUSTA ALLERGY AND ASTHMA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-23",
        "last_updated": "2024-03-05",
        "certification_date": "2024-03-05",
        "status": "A",
        "authorized_official_last_name": "BROOME",
        "authorized_official_first_name": "TRACIE",
        "authorized_official_title_or_position": "OFFICE COORDINATOR",
        "authorized_official_telephone_number": "706-421-1700"
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "GA",
            "license": "045041",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Aquire Health LLC
• Army
• Lawrence Eugene Arrington, M.D.
• Brian Athearn, LDO
• Destanee Atwell
• Augusta Anti-Aging Medicine, LLC
• Augusta Center for Cognitive Behavior Therapy LLC
• Augusta Endoscopy Center, LLC.
• Augusta ENT PC
• Augusta Foot & Ankle, PC

• Allergy & Immunology Physician in Evans, GA
• Providers in Evans, GA by specialty
• Allergy & Immunology Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.