georgia composite medical board minutes of the july 1

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.



2

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SB 32 – do not publish home addresses.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.



3

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.



4

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.



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



6

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



7

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



8

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



9

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



10

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



11

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



12

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



13

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



14

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



15

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



16

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



17

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



18

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



19

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



20

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



21

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



22

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



23

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



24

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



25

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



26

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



27

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



28

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



29

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



30

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



31

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:


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



32

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



33

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

https://gcc02.safelinks.protection.outlook.com/?url=https%3A%2F%2Flinks.casemakerlegal.com%2Fstates%2Fga%2Fbooks%2FCode_of_Georgia%2Fbrowse%3Fci%3D25%26id%3Dgasos%26codesec%3D43-34-25%26title%3D43&data=04%7C01%7Ckierra.battle%40dch.ga.gov%7C464eb91833d1429390ce08d937197b1a%7C512da10d071b4b948abc9ec4044d1516%7C0%7C0%7C637601404833792072%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C1000&sdata=G%2B%2FUQItU1NwbknxzFgueURykigU9u4JNwK3QOAR0lZk%3D&reserved=0



34

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

https://gcc02.safelinks.protection.outlook.com/?url=https%3A%2F%2Flinks.casemakerlegal.com%2Fstates%2Fga%2Fbooks%2FCode_of_Georgia%2Fbrowse%3Fci%3D25%26id%3Dgasos%26codesec%3D43-34-25%26title%3D43&data=04%7C01%7Ckierra.battle%40dch.ga.gov%7C464eb91833d1429390ce08d937197b1a%7C512da10d071b4b948abc9ec4044d1516%7C0%7C0%7C637601404833802030%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C1000&sdata=IFkrrQqInFGOCWVtBcT3aU9wMaKRRdcdLNBBIHlh8Rk%3D&reserved=0



35

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.


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.


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



36


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



37


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.


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



38

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:


Patrick Link Daniel Matricia

Gerald Payne Charangit Shikh

Approved the following applications for additional duties:


Haley Bauguss Blake Willis

Botulinum Toxin Injection



39


Diego Deharo Adam Land

Shoulder Joint Injection

Knee Joint Injection

Closed Reduction of Fracture


Emily Harris Manu Sancheti

Chest Tube placement


Elise Hulsebus Edmond Ritter

Micropigmentation of nipple/arealar complexes


Hilary Karp William O’Connell

Moderate Sedation


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.



40

Overton, Alicia-Reinstatement-240 Shadowing Hours

Answer: Approved

Approved the following Add/Change applications:


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



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



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.



43


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.



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.


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



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.


Approved the following for Initial Perfusion Licensure:

Melissa Bruno

Bharat Datt

Pedro Gallegos

Approved the following for Provisional Perfusion License:

Laurie Baldwin



46

Shivani Williams

Talia Williams

Eric Zheng

ACUPUNCTURE ADVISORY COMMITTEE Dr. Bostock presented the Acupuncture Committee report as a motion and it carried

unanimously.


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.


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



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


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



48


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


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.

.




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.


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.



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



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

georgia composite medical board minutes of the july 1

Documents