georgia composite medical board minutes of the july 1
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Georgia Composite Medical Board
Minutes of the July 1, 2021 Meeting
1
The Georgia Composite Medical Board (GCMB) held its regular meeting on July 1, 2021
via teleconference at 2 Peachtree Street, Atlanta, GA 30303, to consider Medical Board
matters.
Board members on the call:
John S. Antalis, MD
William Bostock, DO
Gretchen Collins, MD
Debi Dalton, MD
E. Dan DeLoach, MD
Charmaine Faucher, PA (ex-officio)
Austin Flint, MD
Judy Gardner, FASHP, Consumer Member
Alexander Gross, MD
Shawn Hanley, Consumer Member
Thomas Harbin, MD, Vice Chair
J. Jeffery Marshall, MD
Matthew Norman, MD
Andrew Reisman, MD
David Retterbush, MD
Barby Simmons, DO, Chair
Management staff present: LaSharn Hughes, MBA, Executive Director
Phyllis White, Executive Assistant
Jonathan McGehee, Director of Investigations
Legal staff on the call: Max Changus, JD, Assistant Attorney General
CALL TO ORDER Dr. Harbin called the meeting of the Georgia Composite Medical Board to order at 7:36 a.m.
AGENDA Dr. DeLoach made a motion, seconded by Dr. Marshall to approve the agenda of the July 1, 2021
meeting. The motion carried unanimously.
MINUTES Dr. Marshall made a motion, seconded by Dr. Reisman to approve the minutes of the June 3, 2021
meeting. The motion carried unanimously.
ELECTION OF OFFICERS The Board voted Thomas Harbin, MD as the Chairman and Debi Dalton, MD as the Vice-
Chairman of the Georgia Composite Medical Board.
EXECUTIVE DIRECTOR’S REPORT Ms. Hughes, Executive Director, presented the following report:
Ms. Hughes met with the Georgia Occupational Regulation Review Council (GORRC) Meeting
held June 16, 2021 regarding HB 811 Licensure and Regulation of Medical Imaging and
Radiation. The Bill is still in review.
Georgia Composite Medical Board
Minutes of the July 1, 2021 Meeting
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Ms. Hughes presented topics for the upcoming newsletter and the strategic plan. She asked the
Board members to review these items for consideration at the August meeting.
The Board accepted as information the following items:
SB 32 – do not publish home addresses.
DPH Commissioner “Letter to Facilitate Broader Provider Access
to Vaccines.”
FSMB US Medical Regulatory Trends and Actions
Overview Physician Licensure
Overview Physician Discipline
Questions regarding who can formally provide a diagnosis of Autism. The Board voted that
physicians, psychologists, advanced practice registered nurses, and licensed clinical social
workers.
Question from Cynthia King asked if is acceptable to utilize unlicensed personnel (such as
ophthalmic technicians) to circulate a laser procedure in a procedure room (not O.R.) with the
attending surgeon present? The board asked for additional information.
RULES COMMITTEE REPORT
Rules for Review:
Motion Dr. Retterbush seconded Dr. Marshall to send the Rules to the Office of the Attorney
General for review and approval prior to posting:
Rule 360-5-.02 “Qualifications for Physician Assistant Licensure”
Rule 360-5-.06 “Renewal of Physician Assistant License”
Rule 360-35-.01 “Definitions” (Lasers)
Rule 360-35-.05 “Practice”
The following Rule will be referred back to the Committee for the August meeting:
Rule 360-16-.01 “Renewal and Expiration Date
Rule 360-5-.12 “Guidelines Concerning Prescriptive Authority”
Rule 360-3-.05 “Medical Assistants, Polysomnography
Technologists, and Radiology Technologists”
CLOSED SESSION Dr. DeLoach motioned seconded by Dr. Dalton to go into closed session to discuss
applications, investigations and disciplinary matters. The motion carried unanimously.
OPEN SESSION Dr. Harbin declared open session.
Georgia Composite Medical Board
Minutes of the July 1, 2021 Meeting
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APPEARANCE BEFORE THE BOARD John Robertson, DO. The Board voted to uphold denial or allow to withdraw.
CLOSED SESSION Dr. DeLoach motioned seconded by Dr. Dalton to go into closed session to discuss
applications, investigations and disciplinary matters. The motion carried unanimously.
OPEN SESSION Dr. Harbin declared open session.
ATTORNEY GENERAL (AG) Max Changus, Assistant Attorney General, presented the AG Status Report. Dr. Marshall submitted
a motion, seconded by Dr. DeLoach and motion carried to accept the report as information and
approved the following Board Orders:
ORDERS FOR APPROVAL: Ayham Haddad—Public Consent Order
20181081
Nazrul Islam, MD—Public Consent Order
Kevin Washington, MD—Public Consent Order
PHYSICIAN LICENSURE COMMITTEE Dr. Retterbush presented the Licensure Committee Report:
The Board took the following actions:
Approve Petition(s) to Waive Rules
Abualruz, Abdul – 360-2.02
Augistine, Santhosh – 360-2 -.01(f)
Chaganty, Kaushik – 360-2 -.01(f)
Meraj, Sumbul – 360-2.02
Merugu, Bhavani – 360-2.02
Questions/Requests
Brason, Dennis – The Board typically requires applicants to rectify issues with other State
Medical Boards prior to submitting an application for a GA medical license.
Clayton, Tenia – The Board requires a license for teleradiology.
Ellis, Justin – Release application material.
Loeffler, Jan – Release medical school transcript, if located.
Georgia Composite Medical Board
Minutes of the July 1, 2021 Meeting
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Approve Physician License Applications:
Bouchez, Jonathan
Prince, Kiersten
Blank, Kenneth
Faruque, Shaheen
Kirkman, Jennifer
Cho, Henry
Feldman, Theodore
Natali, David
Nyaniom, David
Barak, Rakesh
Moody, Candance
Wallace, William
Zamos, David
Paik, William
Salam, Tanvir
Shah, Tushar
Kaminiski, Mark
Rich, Mark
Shang, Jingzi
Brewer, Susan
Approve Institutional License pending:
Genc, Abdulla – additional information
Deny, Withdraw, Clinical Skills or Administrative License:
NH – based on no clinical practice for more than 30 consecutive months.
Interview:
DH
JR
Deny or Withdraw Application:
JJ – based on FL State Board Action and no clinical practice for more than 30 consecutive months.
RN – based on no clinical practice for more than 30 consecutive months.
Deny Application:
Nisar, Pirach – based on criminal conviction.
Georgia Composite Medical Board
Minutes of the July 1, 2021 Meeting
5
ADMINISTRATIVELY APPROVED APPLICATIONS
Name Degree
Abbaszadeh, Ryan V MD
Abdalla, Yoosif MD
Abeibie, Selamawit MD
Abualruz, Abdul R MD
Acevedo Ramirez, Nattasha J MD
Acharya, Manish H MD
Acosta Baez, Giancarlo MD
Acquaye, Joseph K MD
Adams Chunn, David C MD
Adamson, Marissa E DO
Adeyemi, Amidat MD
Adeyeye, Temitope MD
Aguilar, Jessica M DO
Ahmad, Madiha MD
Ai, Di MD
Aitchison, Samantha H MD
Akins, James MD
Aldred, Bruce M MD
Alharthi, Maher S MD
Ali, Kasim M, MD MD
Ali, Munsif MD
Alkubeysi, Mohammed H MD
Allen, Marcus D MD
Alzamora, Patricio S MD
Angulo, Michael D MD
Aquadro, Emily J MD
Arellano, Estylan D DO
Arunachalam, Karuppiah MD
Askeland, Ryan W MD
Asmar, Melissa MD
Assaad, Samer MD
Austin, Jennifer DO
Azumah, Ebere J MD
Azumbrado, Rachel E MD
Babere, Charles C MD
Babolian, Ario MD
Bachier-Rodriguez, Lizamarie MD
Bae, Coney MD
Bansal, Danesh MD
Bar, Barak MD
Georgia Composite Medical Board
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Barmore, LaShelle F DO
Barnes, Whitney A MD
Barnett, Jeala B MD
Barry, James M, III MD
Bascombe, Kristen MD
Bastiaans, Tracey DO
Basu, Suparna MD
Baumgard, Dorothea DO
Bebeau, Katherine A MD
Beckman, Mark D MD
Benjamin, Benson DO
Bermudez Torres, Noemi H DO
Bernardin, Orvenie S MD
Berry, Tommie R, Jr MD
Bertacchi, Kathryn M MD
Bhalla, Harpreet S MD
Bhatia, Ravi D DO
Bhatt, Brian MD
Bivens, Brieanna MD
Black, Evan G MD
Black, Shanekkia L MD
Blackwood, Steven MD
Blech, Benzion C MD
Bliton, John N MD
Borchetta, Kristen M DO
Brandt, Ryan S MD
Brar, Harpreet K MD
Breit, Paula A MD
Brewer, Susan C MD
Broadman, Melissa DO
Brown, Neil G MD
Burandt, Timothy M DO
Burle, Brandi A MD
Burke, Daniel W MD
Burkett, Samuel E MD
Burns, Alana M MD
Busch, Caleb MD
Bustamante, Georgina M MD
Calisi, Nabil MD
Carli, Samuel B MD
Carrau Lebron, Jose L MD
Cassidy, Clifton C DO
Catoe, Benjamin DO
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Chacon, Anna H MD
Chambers, Lacey MD
Chand, Sandeep MD
Chandhoke, Swati MD
Chandler, Chelsea K MD
Chandrashekaran, Satish MD
Chang, Andy L MD
Chekol, Ashebir T MD
Chen, Ricky MD
Chen, Timothy MD
Chin, Justin J DO
Chisholm, Kirby N MD
Chizner, Ryan E DO
Cho, Henry H MD
Choudhary, Fahad K MD
Chukwudelunzu, Felix E MD
Cobb, Janet MD
Cochrane, Katherine MD
Cohen, Ari J MD
Connery, Lisa MD
Coper, Jessica L MD
Couch, Luke L, III MD
Cowart, Richard T MD
Craig, Kathryn MD
Crowley, Michael A MD
D'Agostini, Alexandra MD
Dam, Vincent MD
Dang, Dong MD
David, Miriam MD
Davies, Ryan MD
Davis, Marsha-Gail MD
Dent, Edward A MD
Desai, Harshal A MD
Desai, Neal MD
Desai, Tina MD
DesRochers, Keith D MD
Devireddy, Nithin MD
Dickson, Miriam A MD
Dieringer, Nicholas J MD
Dion, Grace MD
Do, Daniel MD
Dodgen, Amber C MD
Douyon, Philippe G MD
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Dreyer, Diana MD
Dumitrascu, Oana M MD
Dunaway, Kelcey DO
Edwards, Angelique R MD
Eid, Alain A MD
Ejimonyeugwo, Obinna P MD
Ekane, Joan N MD
Eldredge, Kyle S DO
Epps, Shane DO
Ergen, Thomas J MD
Eskew, Lawrence A MD
Esoimeme, Gloria MD
Etebar, Shahin MD
Evans, Samantha MD
Ezeamuzie, Obinna MD
Fadhel, Ehab N MD
Falace, Thomas B MD
Fallen, Amy M MD
Farooq, Muhammad U MD
Favini, Nathan A MD
Feldman, Theodore MD
Fiechter, Brent D MD
Fitzgerald, Caitlyn D MD
Fortes, Daniel L MD
Fraser, Donessa A MD
Frauenhofer, Thomas, Jr. DO
Frazier, Hawwa S DO
Gallo, Bruno MD
Gamboa, Stephen H MD
Gbolahan, Olumide MD
Gehris, Robin P MD
Genovely, Harry C MD
Gentry, Yvette MD
Georgiou, Christopher MD
Ghafarian, Romina MD
Giap, Huan B MD
Gill, Sahib S MD
Gillman, Jennifer MD
Givens, Raymond C MD
Golden, Otashe N MD
Goldshmid, Francis M MD
Gomez, Lissette P MD
Gordon, Brian MD
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Gordon, Gary MD
Graham, Rudi-Ann T MD
Grant, Ryan A MD
Green, Jeremy MD
Griffin, Mervin J MD
Grogberg, David MD
Guo, Huimin MD
Gyr, Leland MD
Gyves-Ray, Katherine M MD
Habashi, Neveen M MD
Halloran, Christian C MD
Hans, Amneet K MD
Hashim, Aly DO
Haupricht, Bradley J MD
Hawes, Ashley H MD
Hayek, Joseph M MD
Hayes, Maria F, MD MD
Haymes, Dalys E MD
Hemphill, Irmanie MD
Henrie, Bradley A MD
Herard, Kimberly MD
Hess, Samuel J MD
Hill, James O, II DO
Hiner, Evan MD
Hoffman, Benjamin H MD
Hoffman, Gregory R MD
Hope, Christopher R MD
Hudgens, Katie M MD
Hurwitz, Stephen S MD
Huynh, Toan T MD
Hwang, Raymond MD
Iames, Edward DO
Infante, Jeffrey R MD
Iqbal, Omar MD
Irani, Shoreh MD
Jarrell, Todd M MD
Jeanneret Lopez, Valerie MD
John, Mohan M MD
Johnson, William M MD
Johnson-Weaver, Joi A MD
Joiner, Aaron A DO
Jones, Christiana N MD
Jones, Stephen MD
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Joseph, Jenny MD
Kagha, Carmen MD
Kahoano, Haku MD
Kakadia, Bhavika B DO
Kalayjian, Tro K DO
Kanter, Jessica R MD
Kapuria, Abhi H MD
Kedem, Roy MD
Kent, Charles W MD
Kerolus, Julia MD
Khan, Imtiaz A DO
Khan, Rumi A MD
Khazaeizadeh, Alireza MD
Khraizat, Hussein C DO
Kim, Joyce J MD
Kim, Yeunjung MD
Kiran, Zahra MD
Kling, Gregg A DO
Koehn, Heather A MD
Kori, Girish MD
Kothari, Kunal MD
Krause, Luke A DO
Krupp, James C MD
Krynetskiy, Evgeny MD
Kurdi, Hussam MD
Landry, Scott H MD
Lane, Morgan E MD
Langone, Anthony J MD
Latriano, Blaise P MD
Lea, William B MD
Lee, Caroline Y MD
Lee, David MD
Leedekerken, Jacob MD
Lehmann, Laura J MD
Lennard, Lyndon B MD
Lewis, Briana R MD
Lewis, O'Dene MD
Liang, Wayne H MD
Lin, Tammy MD
Linfert, Douglas R MD
Litwin, Aileen Joanna G DO
Lopez Diaz, Caroline MD
Lovell, Sabine B MD
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Ma, Yamin MD
Maitre, Nathalie L MD
Majette, Mario L MD
Malak, Ibrahim W MD
Manier, Zachary K MD
Manjunath, Adarsh MD
Mann, Prabeer MD
Mao, Shennen A MD
Martin, Timothy J MD
Masdon, Joshua MD
Matthews, Dennis MD
Mavromates, Nicholas C MD
Mayeux, Trae S MD
Mayhle, Mark D MD
Mayor, Paul C MD
McCabe, James M MD
McClowry, Robert J MD
McCrery, Dennis L, Jr. MD
McFadden, Michael K MD
McGrath, Sean F MD
McMillan, Casey M MD
McMillion, Virgil W DO
McShane, Robert A MD
Mendpara, Rachana C MD
Mereddy, Preethi MD
Middleton, Andrew L MD
Miller, Eric D MD
Minichiello, Michael A DO
Mitchell, Ellen B MD
Mithal, Prabhakar MD
Mixter Leon, Ingrid M MD
Mohamed, Ahmed A MD
Mon, Rodrigo A MD
Montes, Andres MD
Moore, Allison K DO
Morris, Casey H MD
Morton, Janice L MD
Mount, Michael C MD
Muneer, Sumayya F MD
Murray, Mark A MD
Myers, Richard E MD
Nackashi, Andrew DO
Nackashi, Sharon M DO
Georgia Composite Medical Board
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Nandeesh, Bannur R MD
Naqvi, Usker MD
Narayana Rao Gari, Swapna MD
Narayana, Ashwin K MD
Narvaez, Jennifer L MD
Nasr, Michael C MD
Nasworthy, Jeffrey A MD
Ng, Carrie MD
Nguyen, Bao Tram T DO
Nlandu, Zola MD
Nobo, Christopher MD
Nuetzmann, John S DO
Obineme, Chuma G MD
Obiora, Jeffrey C MD
O'Bryan, Edward C MD
O'Carroll, Cumara B MD
Ochije, Sochima I MD
Odunvbun, Precious O MD
Odusanya, Abimbola A MD
Oglesby, Lauren E MD
Oh, Albin MD
Ojukwu, Frederick MD
Oladipo, Olamide DO
Ollivierre Agard, Rachael V MD
Omar, Hesham R MD
Osorio, Carlos E MD
Ottensmeyer, Amy L MD
Pace, Wesley R DO
Palarczyk, Jennifer L DO
Panaitescu, Vlad DO
Pandya, Rajul MD
Patel, Bhavesh MD
Patel, Darshan MD
Patel, Madhuri DO
Patel, Miral M MD
Patel, Neegum G MD
Patel, Nishant D DO
Patel, Pranav M DO
Patel, Reena M MD
Patel, Sajal S MD
Patel, Vishal N MD
Peeples, Natalie B MD
Perkowski, Dayna MD
Georgia Composite Medical Board
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Perre, Anthony MD
Pham, Lily M MD
Pierson, Johnathan T MD
Plamoottil, George I MD
Plunkett, Mark D MD
Powell, Krista M MD
Precht, Hashini K MD
Press, Oliver A MD
Provost, Tyler DO
Pugach, Eugenia DO
Putnam, Tyler MD
Quadri, Syeda F DO
Quigley, Brian P MD
Rad, Jahan MD
Rahal, Peggy N MD
Ramsook, Ryan MD
Rao, Shishir Keekana MD
Rathbun, Kimberly M MD
Ray, Andrew J DO
Raza, Zainab MD
Reddy, Shriya J DO
Reed, Luckey C MD
Reese, Mark F MD
Rice, Bria, MD MD
Ro, Sanghee S MD
Robertson, John Y, Sr DO
Robinson, Kelli MD
Rogers, Thomas, III MD
Rogers, Toby MD
Roseman, Hal M MD
Ross, Courtney MD
Salem, Karma Z MD
Salvana, Jose Feliciano A MD
Sartip, Kamyar MD
Schiff, Julia R MD
Schneider, Helen MD
Schroer, Brady DO
Segal, Robert R MD
Senn, Todd N MD
Shah, Nemil A MD
Shahid, Marika MD
Shahjehan, Rai D MD
Sharma, Sahil P MD
Georgia Composite Medical Board
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Sharpe, Michelle C MD
Shell, Kathryn J MD
Shepherd, Starane A MD
Showalter, Patrick R MD
Shreenath, Aparna P MD
Silva, Patricia MD
Sims, Elise S MD
Singh, Ayush MD
Sipple, Christine A MD
Skaria, Shibu D MD
Skow, Brian S MD
Smith, Jeremy R MD
Smith, Kevin T MD
Socas, Juan MD
Soffer, Robin S MD
Sorchik, Austin DO
Speach, David MD
Staloch, Michael MD
Stein, Marshall J MD
Stewart, Gregory W MD
Strickland, Adrien K MD
Subbarayan, Sreevidya K MD
Sunkara, Srinivas MD
Talbott, Matthew M DO
Tang, Garland J MD
Tangchaivang, Nicholas MD
Tessier, Charles, IV DO
Thakkar, Ashish MD
Thomas, Jackson S, Jackson MD
Thomas, Jincy M MD
Thomas, Samantha C MD
Thomas, Tedra C MD
Thompson, Gregory DO
Thompson, Jerry T DO
Tieszen, Stuart C MD
Tilghman, Craig M MD
Townes, Alexandra M MD
Valleni, Laura A MD
Varkey, Anita B MD
Varrell, James R MD
Vekaria, Shyam MD
Vellanki, Haritha MD
Vieira, Leonardo M MD
Georgia Composite Medical Board
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Waldrop, Joel MD
Walton, Scott MD
Washington, Kimberly R DO
Webster, Elisha E MD
Weingarten, Jeffrey S MD
Weisman, David MD
Welch, George N MD
Weze, Kelechi O MD
Wherry, Thomas M MD
Williams, Penny J MD
Wilson, Natalee K MD
Wilson, Samuel C MD
Wong, Rebecca Y MD
Woodson, Anna L MD
Worthy, Charlita C MD
Xu, William MD
Yarid, Ravi D DO
Yim, So Y MD
Yimer, Nadia M MD
Yoo, David S MD
Yu, Nicholas R MD
Yusuf, Sunday O MD
Zacharias, Nathan A MD
Zahedi-Spung, Leilah D MD
Zavyalov, Erika K DO
Zervos, Aaron-Nickolaos P DO
Zia, Mona MD
Zielke, Kimberly A MD
Zorko, Bryan A MD
Residency Training Permits
Abaza, Suhaib
Abbasi, Zainab
Abdalla, Abubaker O
Abdelgadir, Khalid A
Abe, Tolulope T
Abiodun-Ojo, Olayinka A
Abioye, Adedayo E
Abraham, Fiyinfoluwa O
Abraham, Kalvin A
Abraham, Parisa A
Adodo, Imienreluefe G
Afridi, Sara
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Aggarwal, Tanya
Agor, Akachi P
Ahmad, Ghazal
Ahmed, Maaz Z
Ahoussougbemey Mele, Ange M
Ahuruonye, Chimeziri I
Aje, Omodamola A
Ajulufoh, Miranda C
Akin, Marshall B
Akinboboye, Olawole I
Akinsoji, Elizabeth O
Al Turk, Ahmad A
Alafe, Oluronke F
Alaws, Hossny
Alexandri, Maya
Ali, Sehar S
Ali, Shuaibu
Almquist, Rebecca G
Almubarak, Abdulaziz O
Al-Rusan, Omar M
Altamirano, Fabian A
Amaral Marrero, Claudia F
Amin, Kirtan
Amipara, Rajivkumar G
Anderson, Thomas B
Anees, Moneba
Anthony, Kylie E
Anwanwan, David D
Arceo Olaiz, Ricardo A
Asamoah, Francis A
Ashraf, Muhammad N
Aslanyan, Lilit
Assefa, Beza K
Asthana, Anantratn
Atumonye, Joseph
Auchter, Allison
Augustin, Katrina J
Autry, Prentiss R
Baba, Justin E
Baek, John J
Bahramand, Mustafa
Baig, Asad
Baker, Charles J
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Bala, Sandeep
Banon, Shawn S
Baradaran-Mashinchi, Parastoo
Barboto, Daniel E
Baskaran, Karthikeyan
Bataille, Sebastien E
Baxter, Martin M
Beazer, Jabez K
Beechar, Vivek B
Behbahani, Keywan
Behrman, David B
Benedict, Angel
Bennett, Catherine W
Bentz, Gregory D, Jr
Bezabih, Yihienew M
Bhaskar, Brinda
Bhatia, Neil K
Bhatia-Patel, Sanjana C
Bhushan, Sheena R
Bilak, Michael A
Birdsong, Briana I
Blair, Nicholas M
Blue, Mary M
Bode, Alexander D
Bodunrin, Peter O
Boggs, Corey D
Bonsu, Janice M
Bortfeld, Kristina S
Bou Said, Ryan
Bouchrit, Ghizlane
Bowers, Jacob S
Boyko, Matthew J
Brandenburg, Chandler P
Brands, Susan M
Braun, Hayley A
Bray, Brinkley A
Britt, William M, Jr
Brown, Jaknel
Brown, Joshua D
Burris, Nijah M
Bush, Joseph D
Butler, Jennifer J
Butler, Peter R
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Byers, Elizabeth J
Cabrera, Maximilliam A
Caliendo, Eric T
Callaghan, Spencer V
Callier, Thomas P, IV
Canacevic, Stefan
Candela, Rachael C
Canning, Madison T
Cao, Ying
Capps, Grant M
Carithers, Phillip A, Jr
Casey, Brenna K
Chachar, Atiya
Chakra, Rayen-Ayoub
Chandler, Elizabeth S
Chang, Steven H
Charles, Dudley
Chaudhry, Muzammal S
Chaudry, Bakhtiar S
Chaves, Jose M
Chavez, Thomas F
Chen, Gang
Chirumamilla, Siri L
Choi, Jungwon A
Choudhry, Nimra
Chowdhry, Sarika
Christian, Constance A
Chung, Young Il
Ciuffetelli Alamo, Isabella V
Clark, Abigail E
Clark, Annabelle B
Cohen-Sadan, Shany
Cole, Cedric A
Collins, Alexandra L
Colon-Asumu, Teresa J
Contreras Yametti, Felipe I
Cook, Samuel D
Corbin, Sasha M
Cosgrove, Megan E
Cramer, Jordan L
Croal-Abrahams, Luqman
Cruse, Alyssa R
Cualing, Phillip Y
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Curry, Brian A
Dagher, Lilas
Dakaud Patterson, Alexandra-Elise D
Dalgetty, Mark H
Daniel, Jean-Philippe A
Darby, Derek L, Jr
Dave, Rachna R
Davidson, Brea N
Davidson, Tyler M
Davis, Derick C
Davis, Megan R
de Bruyn, Miko M
Dean, Sophie Y
Dekmar, Buffy F
Delaney, Ashley D
Delsarte, Llewellyn R
DeMaio, Kristine D
Demino, Cory J
Desai, Raj J
Desai, Shreya D
Dighamber, Salony
Dittakavi, Tejaswi S
Dixon, Brandon J
Do, Kevin O
Dodd, Nocholas A
Domaleski, Luke
Dorcius, David P
Dragan, Anamaria
Driessen, Rebecca C
Du, Wendy W
Dugar, Sonal R
Duggan, Alexander K
Dumrongkulraksa, Justin
Durgin, Wesley P
Durkin, Ryan P
Edi, Vivien M
Edwards, Lynnae A
Ehrhardt, Tori F
Ekeledo, Chidi W
Emelogu, Ikenna K
England, Catherine A
Enohnyaket, Esther
Enunwa, Chidiebele A
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Epps, Brandon M
Erem, Anna S
Ermias, Yokabed B
Ervin, Kaitlin Z
Evans, Brooke A
Eyrich, Nicholas W
Fadoul, Peter S
Fareed, Shaaz S
Faustin, Vladimir
Fazal, Rahim K
Fazili, Irtiqa F
Fellows, Megan L
Ferguson, Ryan C
Fernandez, Alyka Glor P
Ferry, Joseph D
Fesseha, Melley Z
Finch, Christina E
Fink, Madelinn R
Fitts, Eric C
Flemmons, Karly K
Florence, Abigail R
Folsom, Brent T
Foster, Millie
Fowler, Joshua A
Franklin, Mathilde W
Franklyn, Lindsey A
Freedman, Nicole L
Fullerton, Farrah Amoy W
Fullmer, Courtney N
Futch, Hunter S
Gaini, Meghana S
Galani, Jemi J
Galante, Eric M
Gambhir, Sheetal
Gandrakota, Nikhila
Garcia, Mackenzie L
Garrett, William M, Jr
Garrison, Stephanie A
Gendrew, Lauren G
Gentry, Jasmine N
Ghanbari, Gilad M
Ghosh, Aditya K
Gibson, Kent T
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Gibson, Lauren
Gichamo, Adanech Z
Gilbride, Carolyn M
Gillet, Aaron S
Gilliard, Cameron N
Gilliland, Brandon S
Gillis, Julianne W
Glassman, Gabriella E
Gloria, Jared N
Godwin, Thomas C
Gopinath, Rishikumar
Gordon, Arianna S
Gordon, Brittney I
Gorham, Jane A
Grady, Zachary J
Graham, Nolan G
Gravenstein, Karling B
Green, Erica A
Greenburg, Logan S
Gregory, Ismail A
Griffin, Kasi K
Griffin, Timothy R
Grimball, Brantley M
Gromer, Daniel J
Grullon Cordoba, Maria A
Guntupalli, Sri Vibhavari
Guo, Zihan
Haff, Stephen B
Hann, Paul F
Hanna, Catherine H
Hansen, Joshua J
Haq, Khadija
Harris, Nile M
Harris, Vandra C
Hart, Lucy D
Hasan, Abdul Mateen M
Hassan, Zakaa A
Hauck, Bryson R
Heatwole, Jennifer L
Helman, Talia A
Hemer, Michelle A
Henderson, Adam C
Hendrix, Bryce A
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Hendrix, Justin R
Henry, Calmour J
Herman, Ashlyn B
Herman, Kathleen J
Herman, Max C
Herweck, Alexandra M
Hester, Jonathan D
Hickman, Scott A
Hill, Raven S
Hill, Ryan
Himes, Alexandra A
Hinds-Pereira, Liana K
Hirsch, Heather M
Ho, Amy X
Hodgeman, Ryan M
Hood, Logan E
Hopkins, Benjamin D
Hornsby, Joshua W
Howard, Ashley R
Howard, Simone M
Hsiao, Jonathan
Hsiao, Wen Yu
Huang, Jingwen
Huffaker, Thomas B
Hughes, Casey A
Huh, Jinsook
Humkey, Kathleen E
Hussain, Farah S
Hussein, Nimo A
Hussien, Jemila A
Indir, Pooja
Isaacson, Katharine C
Ismael, Eman Y
Ismail, Abdullah
Issac, Aaron G
Iyiewuare, Hope
Jackson, Brittany S
Jaferi, Urooj
Jalla, Sri Rasmita
Javadi, Tiffany
Jean, Suzie
Jemal, Abdusebur M
Jenkins, Frances G
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Jessup, Hilary R
Jimenez, Brian F
Jimenez, Samuel
Johnson, Gabrielle S
Jones, Jessica S
Jones, Mackenzie T
Jones, Skyler G
Jones, William G
Joseph, Allan J
Joseph, Morgan D
Kalantri, Pooja
Kalia, Megha
Kanakamedala, Swathi
Kandepu, Jahnavi
Kang, Han B
Kang, Yoona
Kc, Pawan
Kearse, Tiffany M
Keiler, James A
Keyes, Jonathan Z
Khalafalla, Ahmed A
Khan, Adil Y
Khan, Faiza M
Khan, Nafeesa R
Khare, Anshika P
Kim, Daewoong
Kim, Davis Y
Kim, Jun Man
Kim, Paul J
Kim, Soo-Keun S
Kimura, Stephen T
King, Taylore A
Klein, Michael A
Knijnik, Leonardo M
Koch, Rachel L
Koenig, Sydney E
Koundakjian, Dylan C
Krasnow, Maya R
Kristoff, Tyler J
Krouse, Michael C
Kruczek, Alexander G
Krueger, Aaron M
Krupp, James C
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Kuete, Nelson Kevin T
Kumar, Akshay
Lafranchise, Elizabeth A
Lal, Asim A
Lam, Loc P
Lane, Julian D
LaVigne, Caleb A
Le, Nina
Lee, Daniel S
Lee, Hannah H
Lee, Janice J
Lee, John J
Lee, Jun W
Lee, Matthew L
Lee, Michelle R
Lee, Timothy K
Lee, Young C
Legesse, Dereje S
LeMay, Mackenzie M
Lengyel, Krisztina Z
Lertdetkajorn, Khemaporn
Leung, Kimberly S
Levine-Weinberg, Mark P
Lewis, Steven A
Li, Jennifer H
Li, Monica M
Lien, Kinhtu V
Limbaugh, Lindsey J
Limpose, Kristin L
Listur, Alexander B
Llanos, Danielle
Lomax, Justin L
Lopez, Isabel M
Loughran, Kathleen R
Mahadevan, Pranav D
Mahmood, Ahmed M
Malgireddy, Kalyan Reddy
Malhotra, Maansi
Malik, Kashif N
Malki, Jessica C
Manchegowda, Shashidhar
Manson, Bryan K
Manz, Wesley J
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Martin, William C
Martinez, Christian
Masson, Harshvir S
Mbanaso, Alozie A
Mbua, Eric N
McCook, Kem-Maria K
McDonald, Andrew J
McDonough, Kyle R
McElwee, John R
McGinnis, Hamilton S
McGlathery, Gabrielle M
McGrath, Michael W
McGuire, Nicole M
Meadors, Quinten D
Medeiros, Alexandra K
Mehta, Mitesh P
Mehta, Priyanka C
Melvin, Olivia G
Menchaca, John T
Mendoza, Hadrian
Meyer, Hannah M
Mi, Jiaqi
Michel, Donald
Mihilli, Aleksandros
Miller, Stephanie C
Milner, Jeffrey D, II
Mitchell, Victoria L
Mize, Brandi M
Mizell, Marina E
Moazezi, Shauhin S
Mohamed, Alaa S
Mohamed, Ghada A
Mohammaden, Mahmoud H
Mojadidi, Nazira
Molinari, Alexander H
Molloy, Meaghan A
Moraczewski, Jordan A
Murphy, Jordan P
Nadeem, Syed Omair
Narayanan, Mechu M
Naz, Javeria
Neptune, Nathaniel S
Nguyen, Linda
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Nguyen, Thomas H
Nguyen, Vy
Norton, Elizabeth L
Nurani, Aliya S
Nuveen, Nicholas K
Nwanaji-Enwerem, Jamaji C
Nwankwo, Ogechi
Nwebube, Chineze O
Nwoke, Emeka K
Oakes, Chelsea L
Oaks Comer, LaTasha M
Obiorah, Samanthalee C
Ochije, Sochima I
O'Connell, Patrick H
Ogbonna, Precious O
Ogunlari, Olushola
Oh, Kevin
Okoye, Celestina U
Olaosebikan, Kikelomo O
Olatunji, Grace O
Ollawa, Ikechukwu N
Olurin, Darlene W
Olusanya, Oluwaseun R
Omade, Joshua N
Ononuju, Ucheze C
Onyeka, Chinelo N
Oppat, Kailey M
Ortmeyer, Katherine A
Owens, Zachary C
Parikh, Rujul H
Park, Michelle C
Parrish, Ryan A
Pasha, Mohsin I
Patel, Arjun K
Patel, Darren H
Patel, Ektaben M
Patel, Ishani K
Patel, Jay N
Patel, Jimmy
Patel, Kajal A
Patel, Niraj J
Patel, Nirali
Patel, Pujan
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Patel, Sagar C
Patel, Sahil V
Patel, Shalin K
Patel, Shreya R
Patel, Urmi R
Patel, Vidhi A
Patil, Prabhumallikarjun
Paul, Jonathan T
Paykargar, Hossaina
Pearl, Taylor M
Peltier, Bernadette A
Pennoyer, James E
Peralta, Olivia C
Pham, Nguyethang V
Phillips, Taylor B
Poitier, Alexandria T
Ponnatt, Tanya S
Ponraj, Christlin
Pope, Tucker D
Potter, Devin C
Powell, Kelly A
Preslar, Jessica P
Pressman, Alexander J
Price, Sarah R
Priddy, Alexis R
Prynn, Tory A
Puebla, Aaron J
Quebedeaux, Patrick L
Rachh, Pratik V
Ragauskas, Alyse M
Ragazzo, Gabrielle A
Raj, Anjali
Ranski, Alexandra H
Ray, Kristin N
Razalan-Krause, Francheska C
Razavi, Alexander C
Reasor, Joya J
Reehl, David E
Regan, Jacqueline M
Resnick, Daniel
Reyes, Stephanny
Riles, Makayla R
Rizor, James H
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Robinson, Wilton E, Jr
Rodgers, Diana L
Rodriguez Quinonez, Fabian A
Roof, Kelsey A
Roshan, Talal
Ross, Sarah V
Rountree, Chandler A
Rudolph, Christina
Rueda Carrillo, Luis G
Ruiz Vega, Ruben
Rushin, Leah J
Russell, Stephen T
Sadaf, Amina
Saforo, Douglas O
Saklawi, Youssef
Saldana, Alvaro
Salisu, Bisola W
Saltz, Giandor M
Salvatierra, Juan F
Sampat, Pooja M
San, Thinn E
Sanam, Kumar
Sandoval, Mario C
Sankeungassam, Kelly A
Santos, Alexander J
Saraykar, Smita S
Satsangi, Aparna
Savas, Christie S
Schafer, Charles J
Schaffer, Lauren R
Schenkel, Rachel C
Seigel, Clayton S
Semrin, Asmaa
Sessou, Samuel D
Sewell, Arianna F
Shah, Anvay
Shah, Chail D
Shah, Misty A
Shah, Parth A
Shanafelt, Colby D
Sharifai Arabi, Nima
Sharma, Srish K
Sharma, Sumeet
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Shauly, Orr D
Shaver, Adam C
Shaw, Erik C
Sheed, Jatayah N
Shemmiyeva, Maysa
Shepherd, Aaron G
Shiao, Kenneth T
Shibu, Vyshakh M
Sigler, Lauren E
Silverstein, Joshua M
Simmons, Carmen S
Simon, Thomas Jason S
Simpson, Algimantas
Simpson, Francis J
Singapurwala, Mustafa F
Singh, Akaash
Singh, Sarbjit
Sirajuddin, Sarah A
Sircar, Daniel S
Skaf, Daniel A
Slavnic, Bojan
Sligh, Salimah
Smith, Andrew C
Smith, Caitlin N
Smith, Jared D
Smith, Kayla D
Smith, Kiara C
Smith-Wilkerson, Mikhaila A
Smoot, Matthew B
Snider, Jon Abigail
Snitzer, James S
Snyder, Dayton C
Sobash, Philip T
Sogbo, Abla K
Sonkarley, Kiaken
Soriano, Roberto M
South, Chevar O
Spencer, Corey C
Ssempijja, Yvette J
Sterling, Lindsay E
Stout, Adam V
Straka, Sarah E
Subar, Yael G
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Sudan, Nimish
Sudhakar, Vivek R
Suhner, Jessa M
Sumner, William C
Sweeney, Aidan P
Swisher, Shannon K
Tahir, Absar
Talbott, Matthew M
Talukdar, Nina
Tamene, Yonas T
Tannenbaum, Nicholas H
Terry, Dwayne L
Tfaily, Mohamad Ali H
Thomas, Jessica A
Thomas, Oluwadamilola A
Thompson, Aprylle M
Thompson, Bryar S
Thompson, Kentrez G
Tobillo, Rachel A
Todd, Charlotte A
Tolly, Renee L
Triay, Mason E
Tseng, Jasper
Tweardy, Samuel D
Ukoha, Chiamaka J
Upchurch, Patrick A
Van Patten, Hannah S
Van Voorhis, Tristan J
Van, Tam V
Vantipalli, Pavani
Varoqua, Eva
Vavuranakis, Michael A
Veselsky, Steven L
Vogt, Peggy
Waldburg, David L, V
Walker, Kristin V
Wallace, Doyle R
Walls, Sheri P
Walters, Susan M
Ward, Mellissa A
Warnock, William T
Warren, Kwanza T
Weledji, Nelly Marianne T
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Wesley, Elizabeth L
Whitson, Daniel J
Wilder, Samuel G
Wiley, Courtney P
Wilkes, Trevin C
Williams, Carlene A
Williams, Hannah W
Williams, James A
Williams, Justin D
Williams, Monica N
Wilson, Kaamilah A
Windmiller, Reid A
Winzenburg, Camden T
Woldemichael, Bisrat K
Wood, Christopher V
Wood, Sarah J
Woods, Kelsey B
Woubshet, Eden M
Wu, Robert
Yakana-Moyine, Christelle Anais
Yalcin, Emel S
Yarlagadda, Sushuma C
Yeargan, Lauren J
Yong, Alex M
Young, Brandon J
Young, Claire-Louise S
Young, Kate I
Youngblood, Alix E
Yu, Jennifer B
Zamith, Nicholas
Zhang, Suyu A
NURSE PROTOCOL ADVISORY COMMITTEE Dr. DeLoach presented the Nurse Protocol Report:
The Board took the following actions:
1. Does the Georgia Board of Nursing have telemedicine laws/protocols for practices that don't
have a physical location and provide patient care via telemedicine? How can APRNs
practice via telehealth/telemedicine when a physician practice does not exist like the
hospital, clinic, or a traditional office setting? How do other out-of-state providers/groups
practice in Georgia via telehealth/telemedicine? The home where telemedicine will be
practiced can be listed on the agreement. The physician must be practicing medicine
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in the state of Georgia or outside of the state within fifty miles of where the protocol
agreement is being utilized.
2. I am trying to find what is the state laws and regulations regarding IV therapy? This
information can be found on the Secretary of State website under hydration laws. An
NP must submit a protocol agreement to the Medical Board.
3. A delegating physician (as well as designated physician, if there is one) must be within 50
miles from the APRN's practice site? Yes, the physicians must be in the state or out of
the state but within fifty miles of the location where the protocol will be utilized in the
state.
4. Can a Family Practice Physician delegate or designate acts to a Pediatric Nurse Practitioner
or a Family Nurse Practitioner in a pediatric clinic? Yes, the specialties are comparable.
In case of APRN owned practices, will having the physician hired under a contract suffice?
Are there particular specifications or limitations to consider? An NP cannot hire a
physician who will be supervising them.
5. As we discussed, my question concerns the following scenario:
When an APRN/CNM in an inpatient, hospital setting orders the administration of a
“dangerous drug”, as defined by GA Code Sect. 16-13-71, to a patient admitted to the
hospital, is that APRN/CNM required under applicable Georgia Regulations to have 1) a
Nurse Protocol Agreement with a responsible physician and 2) a Nurse Protocol Agreement
which includes Prescriptive Authority?
To put it another way, under applicable Georgia Regulations, would an APRN/CNM be
permitted to order the administration of a “dangerous drug”, as defined by GA Code Sect.
16-13-71, to a patient in a hospital setting 1) without having any Nurse Protocol Agreement
with a responsible physician; and/or 2) without having a Nurse Protocol Agreement with
Prescriptive Authority?
My second question is: Do applicable Georgia Regulations regarding the authority of an
APRN/CNM to issue or write “prescriptions” for medications, including those defined as
being a “dangerous drug” pursuant to GA Code Sect. 16-13-71, only pertain to prescriptions
written by an APRN/CNM for patients on an outpatient basis (non-hospitalized patients) or
do those Regulations also pertain to orders issued by the APRN/CNM for the administration
of such medications to a patient in a hospital setting, i.e., when the patient is hospitalized?
To put it another way, is any distinction made in the Regulations between a APRN/CNM
“writing a Prescription” for a “Dangerous Drug” and “Issuing an Order” for a patient to be
administered a “Dangerous Drug”?
Finally, as far as the scope of the applicable Georgia Regulations are concerned on these
issues – including those identified above - is there any difference between those Regulations
current in effect and those that were in effect in the year 2016? In other words, were the
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Regulations on these topics - - the authority of an APRN/CNM to prescribe and/or order
medications without entering into a Nurse Protocol Agreement with any responsible
physician and/or without being granted prescriptive authority - - the same in 2016 they are
currently. If not, I’d appreciate your identifying any substantive differences. This question
was tabled.
6. Question regarding the 50-mile rule and the number of NP’s that a physician can supervise
when the NP’s fall under an exemption-is the limit eight or is there no cap since the NP’s
don’t count towards the limit? The maximum number of NP’s a physician can supervise
when they fall under an exemption is eight.
7. Does GA view it as a violation if a GA MD supervises 4 Full-time nurse practitioners
practicing in GA and a few nurse practitioners in other surrounding states in compliance
with that state’s supervision laws as well? The services is solo primary care practices, the
physician would be only acting as a supervising physician (no longer in private practice).
The physician has a compact license allowing him to practice in multiple states.
Does GA view it as a violation if a GA MD supervises 4 fulltime APRNs and 4 Pas
practicing in GA and additional APRNs/PA in other surrounding states in compliance with
that states supervision laws? Yes, the physician would be in violation of the Georgia law.
The limit is fur NP’s.
8. A “delegating physician” is defined at reviewing Ga. Code Ann. § 43-34-25(a)(12) merely
as a physician who has entered into a nurse protocol agreement. In the regulation, at Ga.
Comp. R. and Regs. 360-32-.01(11), a delegating physician is defined as a physician who
(a) practices medicine in the State of Georgia; and (b) authorizes an APRN to perform
certain delegated medical acts pursuant to a nurse protocol agreement. The definition in the
regulation, when read in conjunction with the definition of “physician,” which is consistent
between the Code and the Rules as it would apply to an out-of-state physician licensed in
Georgia, seems to imply that the delegating physician must be engaged in the practice of
medicine in Georgia and not merely licensed in Georgia. Is that the case? Yes, the physician
must be practicing in Georgia.
The definition of “physician” in both the Code and Rule states that the physician’s principal
place of practice is within the State of Georgia or is outside the State of Georgia but is within
50 miles from the location where the nurse protocol agreement is being utilized within the
State of Georgia. How is the 50-mile geographic limitation measured in the case of a home
health agency or home-based hospice? Is it measured from the patient’s home or the HHA
or hospice agency office? The distance is measured from the home-based hospice to the
physician’s primary practice address.
The rule, at Ga. Comp. R. and Regs. 360-32-.04(4), states that a delegating physician may
not enter into a nurse protocol agreement with more than four APRN's at any one time. A
delegating physician meeting the provisions of Code section 43-34-25 (g.1) or (g.2), may
enter into a nurse protocol agreement not with more than eight APRNs at any one time, but
may only supervise up to four APRNs at any one time. How do these limitations apply in
the case of a so-called back up delegating physician? In other words, assuming that
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the provisions of Code section 43-34-25 (g.1) or (g.2) do not apply, if a physician agrees
to serve as a backup, does that count toward the limit of four, even if the backup
physician is not actively supervising any other APRNs? I am just trying to get a handle
on the Board’s interpretation of these requirements, so any help you can provide me would
be most appreciated. This question was referred to the Attorney General’s office.
9. Melanie Lieblang’s file- Mrs. LaSharn Hughes- The file was denied because the physician
must be practicing medicine in the state of Georgia.
The following Form C’s were approved:
❖ Bartlett, Sonja
❖ Barnett, Mallory
❖ Edgar, Stacy
❖ Evans, Angela (Form C Petition)
❖ Evans, Kimberly
❖ Fiveash, Taylor
❖ Lake, Dorothy
❖ Moesch, Julie
❖ Ondieki, Damaris
❖ Rizkalla, Chelsea
❖ Rosser, Teressa
The following Form C’s were not approved:
❖ Pulliam, Cayla
The Committee reviewed and approved the following protocols under the provision of
O.C.C.A. 43-34-25.
APRN Delegating Physician
Bennett, Lila (resubmit) Daryoosh Derakhshan, DO
Boree, Charity Stephen Chitty, IV, MD
Campbell, III, James (resubmit) David Samuels, DO
Charles, Connie (resubmit) Paul Karagiannis, MD
Clark, Melissa (resubmit) Kayln Lane, MD
Clark, Stephanie David Jones, Sr., MD
Coleman, Danielle Nia Sipp, MD
Copeland, Vanessa (resubmit) Chukwuemeka Nwabuebo, MD
Day, Esther Dinesh Raju, MD
Johnson, Lesa Alan Sanders, MD
Lewis, Beth Gary Stern, MD
McIntosh, Chasitie Cassandra White, MD
Merritt, Amanda John Hemphill, MD
Momin, Arshiya Melvin Williams, Jr., MD
Morgan, Trai Gabriel Onofre, MD
Morris, Sara Gabriel Onofre, MD
Moye, Angie Katherine Moretz, MD
Widener, Wallette John Hemphill, MD
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Wilke, Kimberly Stephen Yost, DO
The Committee determined that the following protocol agreements meet the provisions of
O.C.G.A. 43-34-25 with changes.
APRN Delegating Physician
Eckert, Cynthia Karen Gilson, MD
Fagan, Melissa Gabriel Onofre, MD
Finney, Jennifer Modele Ogunniyi, MD
Fuller, Chevita Obinnaya Emerole, MD
Hayes, Hannah Benjamin Lee, MD
Henry, Millicent Fady Henein, MD
Miller, Tanya Ram Bishnoi, MD
Settle, Lauren Allen Dollar, MD
The Committee determined that the following protocol agreements do NOT meet the
provisions of O.C.G.A. 43-34-25.
APRN Delegating Physician
Adiodun Dolapo Asaf Aleem, MD
Bates, Tiffany Gregory Lunceford, MD
Clark, Jeanine Dewitt Alfred, III, MD
Evans, Meredith (resubmit) Deborah Hansard, MD
Ford, Deborah Mark Taylor, MD
Hicks, Amy Katherine Wiegman, MD
Odero, Beatrice Rade Vukmir, MD
Patterson, Joanne Sarita Prasad, MD
Tessema, Yetnayet Lisa Rudolph Wilson, MD
Protocols Administratively Reviewed:
The following protocol agreements meet the provisions of OCGA 43-34-25:
APRN Last APRN First Middle Delegating Physician Name
Abon Moradeke Rodneysha Brown
Agabin Nataly Michael Friedman
Anderson Letitia Fred Reifsteck, III
Annunziato Britney David Rowe
Atha Mary Nadine Rouphael
Aura Joan David Nussbaum
Barnes Shelia Michael Gonsalves
Battaglia Taylor Shelley Dunson-Allen
Bibisi Lucy Kevin Pharris
Blayton Ashley Beatrice Clodomir
Brooks Hannah Tuvia Breuer
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APRN Last APRN First Middle Delegating Physician Name
Campbell, III James Heywood Gay
Carney Julie Daisy Lim
Cheney Teresa Scott Mikell
Clark Kendall Joseph Jackson, Jr.
Coffey Jacey Kimberley Ham
Connor Lisa Jigish Sheth
Coryell John Robert Cook
Crane Ayers Heather Brian Barczak
Crowe Julia Fred Reifsteck, III
Dexter Susan Khudr Burjak
DiGirolamo Sarah Stephanie Gordon
Drummond Alixandria Sohel Momin
Duerk Shannon Adaora Osa Kwe
Dunlap Marlis Robert Martin
Duru Trisha J Norris
Effinger Portia Edward Gotlieb
Filer Jennifer Mohsin Hisamuddin
Flaherty Kathleen Thomas Holmes
Fodor Whitney Jabeen Taj
Ford Deborah William McLarty, Jr.
Francis-Agalaba Constance Asaf Aleem
Gibson James Fred Reifsteck, III
Greene Angela Sarah Smith-Thompson
Hall Catherine Peter Rosenquist
Hines Davelyne Elving Colon
Holloway Deena David Starr
Holmes Charisse Newton Chism, Jr.
Holton Philip John Gerguis
Hunter Genner Lamar Ward
Jackson Anitra Mark Feeman
Jackson Missy Sarah Smith-Thompson
Johnson Nicole Jonathan Chen
Jolly Sherita Javeria Bhawal
Jones Amanda DeAnn Bing
Jordan Sarah Raul Lopez
Joshi Shawna Marisa Chavez
Keenan Kayla Salvatore Chillemi
Lewis Collen Sagar Lonial
Marcius Marva Andrea Kovack
Martindale LaWanda Casey Henritz
Mason Grace Sara Gladney
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APRN Last APRN First Middle Delegating Physician Name
Mortez Tonya Matthew Davis
O'Conner Tanisha Natalie Godbee
Ragland Morgan Tarak Patel
Schoen Eleanor Divya Gupta
Stewart Dana Maxwell Parrott
PHYSICIAN ASSISTANT ADVISORY COMMITTEE Dr. Antalis presented the Physician Assistant Committee
report.
The Board took the following actions:
Approved the following applications for initial licensure with a supervising physician:
PA Supervising Physician
Amelia Andrews Muhammad Jamil
Jordan Barr Charles Stewart
Luminita Dumitru Gabriela Pena
Julie Harmon Phillip Gray
Erin Martin Robert Titelman
Olivia Neeley David Samuels
Nikita Patel Natalie Dean
Jonathan Riordan Rahim Wooley
William Sellars David Brcka
Anna Slifko Jason Smith
Allison Springston Robert Mazur
Cecilie Stegeman Benjamin Strong
Elizabeth Thomas Jameson Estes
Cassondra Walker Martin Hardy
Michael Wenclawiak Christopher Piller
Nisma Zbib Mohammad Ahmad
Approved the following applications for initial licensure without a supervising physician:
PA
Angelina Akotsen-Mensah
Jimmy Andazola
Kailey Barfield
Anna Johnson
Bridgette Beattie
Carmelle Beauvais
Mallory Bellissimo
Stephen Bradlyn
Kynlea Brantley
Clinton Brif
Chad Brooks
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Raquiah Carter
Caitlyn Cartwright
Naika Castma
Jill Chang
Victoria Contreras
Ivy Cook
William Durden
Dorothy Faber
Sydney Funderburk
Brittney Jeffrie
Lindsey Lawrence
Rawan Majdalawi
Evan Markell
Corinne McCullion
Jessica McDaniel
Mollie Michel
IIana Muller
Griffen Mullins
Hannah Oliver
Nidhi Parekh
Rachel Rapp
Sarah Recupero
Yosef Seewald
Savannah Sessions
Nadine Somerville
Kimberly Straub
Madison Tanner
Madison Taylor
Brian Watson
Courtney Wedgeworth
Erica Williams
Taylor Winslow
Sydney Wyatt
Approved the following applications for licensure reinstatement with a supervising
physician:
PA Supervising Physician
Patrick Link Daniel Matricia
Gerald Payne Charangit Shikh
Approved the following applications for additional duties:
PA Supervising Physician
Haley Bauguss Blake Willis
Botulinum Toxin Injection
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PA Supervising Physician
Diego Deharo Adam Land
Shoulder Joint Injection
Knee Joint Injection
Closed Reduction of Fracture
PA Supervising Physician
Emily Harris Manu Sancheti
Chest Tube placement
PA Supervising Physician
Elise Hulsebus Edmond Ritter
Micropigmentation of nipple/arealar complexes
PA Supervising Physician
Hilary Karp William O’Connell
Moderate Sedation
PA Supervising Physician
LaSonja Reeves Chris Horn
Intrathecal Medication Administration
Central Line Insertion
Arterial Line Insertion
Other Business:
Barker, Caroline – Initial PA Applicant. Approve with additional information.
Haarmann, Brett – Reinstatement Applicant, approved
Fullmer, Dana, Matrix Medical Network – asked for clarification on PA and Supervising
Physicians oversight/supervision requirements in GA. Refer to the law.
Michewicz, Elaina, University of Michigan – research regarding practice of medicine and
licensure for telehealth purposes.
Answer: Yes, Physician Assistant needs to be licensed in Georgia
Answer: Yes, Physician Assistant is required to have a Georgia licensed physician
supervising.
Schroeckenthaler, Sara – Clarification of designation of PCP’s.
Answer: Board cannot answer legal questions, please refer to the law.
Tekin, Clark – Clarification of Volunteer Temporary Practice Agreement.
Answer: Information listed on the website has not changed. We do not print approval
letters for this type of request.
Georgia Composite Medical Board
Minutes of the July 1, 2021 Meeting
40
Overton, Alicia-Reinstatement-240 Shadowing Hours
Answer: Approved
Approved the following Add/Change applications:
PA Supervising Physician
Shukufa Abdul-Wahab Jason Springer
Anthony Ambrose Stephanie Busby
Douglas Amis Victor Orellano-Noia
Emily Andreano Martha Schuh
Lacey Ante Chirag Dave
Samantha Ashmead Martha Schuh
Daniel Ayers William O’Connell
Daniel Ayers Bill Majdalany
Maura Barrett Steven Bomeli
Lisa Bartlow Brian Freeman
Haley Bauguss Blake Willis
Haley Bauguss Joyce Akwe
Cristina Bayardelle Stefan Erceg
William Bence Sidney Bedell
Easton Beshears Douglas Redd
Cunardline Bienvenu-Sumpter Aaron Fletcher
Ashley Boachie-Adjei Tamara John
Lee Brandt, Jr. David Katz
Kimberly Brown Rhett Rainey
Edmund Burdo Sidney Bedell
Joseph Carlson Sean Crane
Abbey Chatmon Sang Dau
Jennifer Chen Cassandra Donnelly
Sheryl Chiariello Sabina Siddiqi
Courtney Conley Martin Dixon
Robert Coste Nabeel Khan
Robert Coste Sabina Siddiqi
Joseph Craig Ashley Varner
Ralph Dapaah Christopher Paul
John Dorough Thomas Street
Elizabeth Draper Rachel Steckelberg
Lauren Dubberly Frank Bixler
Cayla Eller Devin Weinberg
Aleksandr Fedovskiy Sue Han
Thomas Feil Robert Guyton
Fedlande Ferjuste Sowmya Barrela
Anum Gaffar Sophia Goodridge
Ashley Gantt Mircea Cristescu
Thomas Gauldin Michael Halkos
Megan Gerrells Robert Thompson
Georgia Composite Medical Board
Minutes of the July 1, 2021 Meeting
41
Clarence Godfrey Alexa Ron
David Goins Roberto Lopez Vega
Giovanna Golem Richard Sola
Daniel Hamlin David Hatmaker
Elizabeth Heard Nathan Ertel
Andrew Hendley Scott Solomon
Andres Hernandez Thanayi Barone-Smith
Sally Hoang Obinwanne Emejulu
Jessica Hoeffler Bernadette Wang
Mollie Hosfeld William Boling
Dawn Howell Marco Hallerbach
Joshua Howard Jason Holmes
Kierney Jackson Christopher Everett
Grier James Sabina Siddiqi
Emily Jamshedi Melody Bray-Ross
Ronald Jennings Kendra Grubb
Ronald Jennigs Thomas Fitzsimmons
Christopher Johanson Alisa Horsford
Kristen Jones Roland Pinkney
Whitney Jones Edward Liebzeit
Anish Joseph Susan Smith
Mitzi Kabore Yetunde Orimogunje
Melissa Kaszak Taylor Plumer
Jinal Khamar York Chen
Elaheh Kheirbakhsh Khalique Rehman
April Kooy Tulasi Vanapalli
Meghan Kosiba David Pae
Tatiana Martinez Sinan Haddad
Nicole Lytle Russell Brown
John McDowell Andrew Johnson
Scott Luft Andrew Page
Nili Nourparvar Jess Schwartz
Claire Wan Aneesh Kautilya
Lyna Tran Danielle Hines
Stanley Lawhon Jon Varias
Le Cuong Lal Neena
John Paul Le Obinwanne Emejulu
Devin Martin Joshua Egly
Devin Martin Roberto Lopez-Vega
Kevin Nguyen Hedayah Scoon
Nasra Osman Nidhi Huff
Mark Ritchie Roberto Lopez-Vega
Mark Ritchie Santhana Sriradchatha
Daniel McCarthy Peter Wrobel
Brian Leland Daren Newfield
Rachel Melton Reginald Davis
Tammy Luu Aashish Patel
Georgia Composite Medical Board
Minutes of the July 1, 2021 Meeting
42
Patricia Miller Jimi Malik
Erica Pena Steven Ha
Ryan Plowman Reginald Davis
Kerry Shuffelbottom Andrew Pandya
Joshua Skelton Todd Sacks
Sharon Xiques Paul Boyce
Thomas Sheridan Wendy Neveu
Jodee Stevens Megan Durham
Lucas Trower Susan Smith
Melissa Williamson Ryan Box
Twanya May Martha Schuh
Tyler Seals Tesfaye Talila
William Strickland Dingane Baruti
Ryan Troup Bradley Wallace
Kristina Lowe Ritesh Shah
Christopher Yegge David Neujahr
Christopher Yegge Mani Daneshmand
Xiao Taing Harold Minerve
Renee Thomas Neil Resnick
Renee Thomas Mohammed Loya
Dana Simpson Raymond Moody
Kassandra Torres Evgeny Krynetskiy
Jason Spencer Young Chai
Michael Martin Hedayah Scoon
Reginald Malone Dan Sorescu
Angela Marquis Gary Siegel
Joshua Widner Michael Liu
Shelley Staton Michael Anthony
Louis Saez Taylor Plumer
Lauren Osborne Michael Liu
Cynthia Wea Ronnie Zeidan
John McDowell Nicola Lee
Nicolai Pineda Martin Dixon
Jason Lunsford Brian Ludwig
Robert Whitener Mofolasade Adeyi
Claire Murphy Chuc Pham
Elizabeth Rambo Nagender Mankan
Larry Thomas Henry Rachal
Jordan Martinec Stephen Skidmore
Elizabeth Thompson Zaneb Yaseen
Sonya Winborne Scott Conard
Amanda McCook Garland Martin
COSMETIC LASER ADVISORY COMMITTEE Dr. Gross presented the Cosmetic Laser Committee report as a motion and it carried
unanimously.
Georgia Composite Medical Board
Minutes of the July 1, 2021 Meeting
43
The Board took the following actions:
Approved the following for Assistant Laser Practitioner –
Angelika Barros
Nykeva Blake
Ebony Brown
Ashley Clark
Kimberly Dennis
Hannah Dounis
Daphne Dunbar
Zipporah Ford
Cassandra Glivic
Carole Howard
Elizabeth Johnson
Latoyia Johnson
Tracy Kennedy
Kyung Maddelena
Jasmine Magee
Belina Matias
Melissa Methvin
Cori Musser
Hailee Nichols
Jennifer Pantoja-Chavez
Shaina Paul
Kaitlin Pruitt
Carl Robinson
Chaka Sims-Kelley
Madison Smith
Approved the following for a reissue of Assistant Laser Practitioner –
Margaret Amundsen
Amy Kohel
Valencia Morris
Danelle Wilson
Approved the following for Senior Laser Practitioner –
Molly Furlow
Approved the following for a reissue for Assistant Laser Practitioner with conditions:
C.W.
Other Business:
The Board approved Mr. Patrick Clark and Mr. John Hoopman as ACCME-certified trainers.
Georgia Composite Medical Board
Minutes of the July 1, 2021 Meeting
44
RESPIRATORY CARE ADVISORY COMMITTEE Dr. Dalton presented the Respiratory Care Committee report as a motion, seconded by Dr.
Marshall. The Board accepted the report by unanimous vote.
The Board took the following actions:
Practicing without a license; Fine and Consent Order
SH- Reinstatement
Reinstatements; 4 of 6 approved: 2 pending documentation
Basey, Krystal
Johnson, Anthony
Olds, Vanessa
Young, Justin
Rosema, Pamela- pending additional information
Smith, Bree- pending additional information
Temporary Licensure; Andrew College: 6 of 6 approved
Wesley, Taliah
Walls, Kimberly
Tyson, Jacklyn
Edwards, Heather
Cruel, Brittany
Barnes, Courtney
Temporary Licensure; 6 of 6 approved
Killingsworth, Michael
Brown, Symone
Ledbetter, Morgan
Paul, Catherine
Morris, Brittany
Chambliss, Jessica
Full Licensure; 34 of 37 approved: 3 pending documentation
Gilbert, Allison
Patel, Shahin
White, Patricia
Pratt, Sherri
Chamberlin, Mary
Hannah, Harlissa
Polk, Robyn
Williams, Matthew
Darling, John
Chisholm, Michael
Daniels, Carolyn
Hart, Jacquelynn
Maki, Jennifer
Georgia Composite Medical Board
Minutes of the July 1, 2021 Meeting
45
Ray, Alona
Winburn, Lauren
Miller, Kaleleak
Essex, Kimberly
Moses, Amanda
Grant, Kimberlie
Laing, Shamoya
Bascom, Anishhka
Foster, Danielle
Hunt, Preston
Moss, Tuwanna
Scott, Monique
Holoway, Brian
Sylien, Gaelle
Garr, Emily
Jackson, Joshua
Mullis, Bailey
Troiani, Ariel
Burns, Jason
Meggo, Michael
Aguirre, Terese
Guy-Johnson, Candyce- pending additional information
Johnson, Jeffrey- pending additional information
Rush, Curtis- pending additional information
Administrative Upgrades
Emily Price
Terrell Williams
Courtney Foney
Jennifer Rodriguez
Jordan Warner
Chanel Henry
PERFUSION ADVISORY COMMITTEE Dr. Marshall presented the Perfusion Committee report as a motion and it carried
unanimously.
The Board took the following actions:
Approved the following for Initial Perfusion Licensure:
Melissa Bruno
Bharat Datt
Pedro Gallegos
Approved the following for Provisional Perfusion License:
Laurie Baldwin
Georgia Composite Medical Board
Minutes of the July 1, 2021 Meeting
46
Shivani Williams
Talia Williams
Eric Zheng
ACUPUNCTURE ADVISORY COMMITTEE Dr. Bostock presented the Acupuncture Committee report as a motion and it carried
unanimously.
The Board took the following actions:
Accepted the following quarterly report:
Jennifer Parsons
Approved the following for initial acupuncture licensure:
Monica Garcia
Woojin Park
Tabled the following for initial acupuncture licensure:
A.F. – clarification of work history information
Other Business:
Accepted as information the list of limited licensees and supervisors.
PAIN MANAGEMENT COMMITTEE Dr. Collins presented the Pain Management Committee report as a motion. The Board
accepted the report by unanimous vote.
The Board took the following actions:
Approved the following for pain licensure:
Application or File #: Pain Clinic
F558243 Nexus Pain Center- LaGrange
License # 388 Advanced Pain and Rehabilitation P.C.- Atlanta
Renewal Application License # 258 Summit Spine & Joint Centers (several locations)
Renewal Application
The Committee tabled the following renewal application pending further information
License # 135 Powell Total Medical-Kingsland
Renewal Application
The Committee ordered a fine and Consent Order for unlicensed practice:
20220004
Georgia Composite Medical Board
Minutes of the July 1, 2021 Meeting
47
The Committee determined additional information is needed regarding Christopher Roberts, MD
and Claudio Vincenty, MD disciplinary actions against them. The Committee also determined clinic
is operating without a proper ownership license and should be fined.
License # 201 Consultants in Pain Medicine, LLC- Brunswick
Change of Ownership and Rules Waiver Petition
Administratively Approved Applications:
Application or File #: Pain Clinic
150,250,322,323,325,328,333,375 Alliance Spine and Pain Centers
DELETE Practicing Physician, David Rosenfeld
150,248,322,323,324,325,328,333 Alliance Spine and Pain Centers
DELETE Practicing Physician, Pickens Patterson III
248 Alliance Spine and Pain Centers
DELETE Practicing Physician, Shawn Cable
250,324 Alliance Spine and Pain Centers
DELETE Practicing Physician, Efosa Ogiamien
324,326 Alliance Spine and Pain Centers
DELETE Practicing Physician, Omar Hajmurad
375 Alliance Spine and Pain Centers
DELETE Practicing Physicians, Ramon Espinal,
Michael Schaufele, Shawn Cable & Allen Hord
349,508 Medici Medical Arts, LLC
DELETE Practicing Physician, Casey Leong
523 Centurion Spine & Pain Center
DELETE Practicing Physician, Hares Akbary
411 Summit Spine & Joint Centers
ADD Practicing Physician, Adam Gover
412 Summit Spine & Joint Centers
ADD Practicing Physician, Celine Mathew
269 Ellis Pain Center
DELETE Practicing Physician, Christopher Sellars
121,122 The Physicians Spine and Rehabilitation Specialists of
Georgia PC
DELETE Practicing Physicians and Owners,
Charles MacNeill, John Porter, Christopher Paul
Georgia Composite Medical Board
Minutes of the July 1, 2021 Meeting
48
375 Alliance Spine and Pain Centers
ADD Practicing Physician, Shalin Shah
ADD APRN, Lindsey Mears
322, 323 Alliance Spine and Pain Centers
ADD Practicing Physician, Eduardo Escorcia
121,123 The Physicians Spine and Rehabilitation Specialists of
Georgia, PC
DELETE Practicing Physician, Ankur Patel
447 Spectrum Spine and Pain Care
ADD APRNs, Jessica Le and Kristel Schrils
ADD Managing Employee, Kayla Soucy
465 Spectrum Spine and Pain Care
ADD APRN, Kristel Schrils
ADD Managing Employee, Kayla Soucy
279 The Nexus Pain Center of Columbus, LLC
ADD Practicing Physician, Angela Strother
323 Alliance Spine and Pain Centers
ADD Practicing Physician, Preeti Narayan
121,22,123,513 The Physicians Spine and Rehabilitation Specialists of
Georgia, PC
ADD PA, Emma Goldman
422 Center for Spine and Pain Medicine
ADD Practicing Physician, Venu Madhipatla
476,477,478 Axis Pain Center
ADD Practicing Physician, William Smisson
201 Consultants in Pain Medicine
DELETE Practicing Physician, Thomas Runyan
277,288 My Pain Clinic
ADD PA, Elaheh Kheirbakhsh
GENETIC COUNSELORS ADVISORY COMMITTEE
Dr. Deloach presented the Genetic Counselors Advisory Committee report.
.
The Board took the following actions:
Georgia Composite Medical Board
Minutes of the July 1, 2021 Meeting
49
Possible Unlicensed Practice
The Committee reviewed an email regarding possible unlicensed practice. The matter was referred
to Investigations.
Applications Approved:
Jordan Berg Joseph Biddle - Temporary license
Victoria Blank
Sheena Byerly – Temporary license
Emalyn Cork
Leigh DeHoll
Casey Duld
Anna Dunn
Katherine Hornberger
Kia Hutchins – Temporary license
Sunaina Kapur - Temporary license
Lauren Murphy
Megan Myers
Katie Rembisz
Quinn Stein
Amelia Tahmassi
O & P ADVISORY COMMITTEE
Dr. Bostock presented the O & P Advisory Committee report.
The Board took the following actions:
Approved the following application for licensure:
Jenna Sabato - Orthotist
Tabled the following application:
C.H. – Orthotist licensure – needs required education and ABC certification
Other Business:
The Committee refers the email from Tisha Byman (regarding scope of practice for a
certified orthotic fitter) to the Attorney General’s Office.
WELLNESS COMMITTEE REPORT
The Wellness Committee made the following recommendations to the Board:
PHP Report
Dr. Earley & Ms. McCown provided the Board an update on cases with the PHP. The Committee
accepted the report as information.
Georgia Composite Medical Board
Minutes of the July 1, 2021 Meeting
50
Non-Interview Matters
AK - table obtain additional information from the PHP
KB - table for additional information from Investigations.
SP - interview
JGR - table for additional information.
20200435 – at Attorney General Office.
INVESTIGATIVE INTERVIEW REPORT Dr. Gross presented the Investigative Interview report as a motion, and was seconded by Dr. Antalis. The
Board accepted the report unanimous vote. The Board took the following actions.
20210912 Letter of Concern
INVESTIGATIVE COMMITTEE The Investigative Committee report was presented as a motion by Dr. Gross and was seconded by Dr.
Antalis. The Board accepted the report unanimous vote. The Board took the following actions.
Close:
20170794 20181168 20182129 20192387 20200560 20200913
20201112 20201628 20210012 20210342 20210502 20210578
20210629 20210759 20210829 20210837 20210884 20210901
20210915 20210920 20210965 20210974 20210982 20211018
20211025 20211028 20211031 20211045 20211057 20211087
20211095 20211100 20211104 20211111 20211113 20211118
20211122 20211130 20211135 20211138 20211143 20211145
20211146 20211153 20211156 20211163 20211164 20211171
20211185 20211199 20211201 20211203 20211205 20211209
20211216 20211231 20211254 20211259 20211268 20211270
20211273 20211275 20211276 20211281 20211288 20211289
20211290 20211310 20211312 20211313 20211325 20211334
20211344 20211345 20211350 20211360 20211374 20211377
20211378 20211389 20211397 20211414 20211416 20192593
20200317 20200366 20201012 20201102 20201430 20201617
20210033 20210142 20210216 20210235 20210412 20210516
20210817 20210924 20210986 20210999 20211197 20211229
20211249 20211250 20211252 20211284 20211316 20211352
20211399 20211418 20211533
Letter of Concerns:
20181187 20182263 20210037 20210240 20211098
20211117 20211176 20211198 20211204 20211219 20211232
20211257 20211368 20211388 20211394 20211530
Georgia Composite Medical Board
Minutes of the July 1, 2021 Meeting
51
Further Investigation:
None
Invite for Investigative Interview:
20201315 20201586 20210745 20210922 20210923 20211261
20210573
Table
20210018 20210075 20210098 20211017 20211322 20211358
20211417 20211483
Referred to Attorney General’s Office
20210358 20211065
Peer Review
20192591 20192592 20201616 20210573 20211347
INITIAL COMPLAINT EVALUATIONS
The Board approved the following recommendations.
20211266 20211482 20211485 20211501 20211522 20211527
20211528 20211568 20211589
RECUSALS NONE
LAW ENFORCEMENT ADVISORY REPORT The LEAR report was presented as a motion by Dr. Gross and was seconded by Dr. Antalis. The
Board accepted the report by unanimous vote. The Board took the following actions.
1. 20171262 – Approve the release of information
2. 20160160 – Approve Termination of Probation
3. 20180223 – Approve Order of Completion
There being no further business, motion Dr. Flint, seconded Dr. Marshall to adjourn the
meeting at 12:11p.m.
__________________________________ ________________________________
Thomas Harbin, MD LaSharn Hughes, MBA
Chairperson Executive Director
Recorded by:
________________________________________ Phyllis White, Executive Assistant
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