TATTNALL HOSPITAL COMPANY, LLC (NPI# 1154614360) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154614360 |
| Entity Type | Organization |
| Organization Name | TATTNALL HOSPITAL COMPANY, LLC |
| Other Organization Name | OPTIM PRIMARY CARE-VIDALIA |
| Practice Address |
1811 Edwina Drive Vidalia GA 30474 |
| Mailing Address |
210 E. Derenne Ave Savannah GA 61405-6736 |
| Practice Telephone | 9125379779 |
| Practice Fax Number | 9125372124 |
| Mailing Telephone | 9126445300 |
| Mailing Fax Number | 9126445260 |
| Enumeration Date | 2011-05-20 |
| Last Update Date | 2012-01-10 |
| Authorized Official Name | MICHAEL W. KLEINPETER (CEO) |
| Authorized Official Telephone | 9126445300 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Optim Primary Care-Vidalia | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912566811 | Tattnall Hospital Company, LLC | Clinic/Center | 10200 Ford Ave Ste 105, Richmond Hill, GA 31324-8824 | 2019-06-13 |
| 1285132415 | Tattnall Hospital Company, LLC | Family Medicine | 380a Cedar St, Metter, GA 30439 | 2018-01-23 |
| 1558878884 | Tattnall Hospital Company, LLC | Neurological Surgery | 242 Industrial Blvd, Dublin, GA 31021 | 2018-01-09 |
| 1093115123 | Tattnall Hospital Company, LLC | Neurological Surgery | 3345 Us Highway 84, Suite 100, Blackshear, GA 31516-2159 | 2014-08-26 |
| 1790112571 | Tattnall Hospital Company, LLC | Surgery | 1702-a Meadows Lane, Vidalia, GA 30474 | 2013-10-10 |
| 1720322464 | Tattnall Hospital Company, LLC | Orthopaedic Surgery | 38 S. Tallahassee Street, Suite B, Hazlehurst, GA 31539 | 2012-11-19 |
| 1013261312 | Tattnall Hospital Company, LLC | Physical Medicine & Rehabilitation | 8. North Williams Street, Metter, GA 30439 | 2012-11-08 |
| 1245501063 | Tattnall Hospital Company, LLC | Physical Medicine & Rehabilitation | 5918 Ogeechee Rd, Savannah, GA 31419-9527 | 2012-01-25 |
| 1891009924 | Tattnall Hospital Company, LLC | Orthopaedic Surgery | 110 East Tollison Street, Baxley, GA 31513 | 2010-07-30 |
| 1356579296 | Tattnall Hospital Company, LLC | Physician Assistant | 230 Industrial Blvd, Dublin, GA 31021 | 2009-06-30 |
| Street Address |
1811 EDWINA DRIVE |
| City | VIDALIA |
| State | GA |
| Zip Code | 30474 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730655374 | Abby Virginia Adams | Speech-Language Pathologist | 101 Harris Insustrial Blvd, Vidalia, GA 30474 | 2018-10-22 |
| 1467930156 | Laurel Shiver Sapp | Nurse Practitioner | 1608 Meadows Ln, Vidalia, GA 30474 | 2018-08-03 |
| 1235658931 | Mary Frances Andrews | Nurse Practitioner | 1608 Meadows Lane Suite 1, Vidalia, GA 30474 | 2017-09-13 |
| 1154714574 | Georgia Eye Institute of The Southeast, LLC | Optometrist | 104 Andrews Street, Suite 112, Vidalia, GA 30474 | 2015-03-10 |
| 1790112571 | Tattnall Hospital Company, LLC | Surgery | 1702-a Meadows Lane, Vidalia, GA 30474 | 2013-10-10 |
| 1801235312 | Paul Anderson Youth Home, Inc. | Substance Abuse Rehabilitation Facility | 1603 Mcintosh Street, Vidalia, GA 30474 | 2013-06-18 |
| 1043591076 | Kimberly Thigpen Evans | Nurse Practitioner | 621 East First Street, Unit B, Vidalia, GA 30474 | 2011-09-03 |
| 1255586053 | Vidalia Medical Partners Inc. | Home Health | 801 Mcnatt Street, Vidalia, GA 30474 | 2008-11-20 |
| 1154596419 | Jill Nicole Lawrence | Speech-Language Pathologist | 1400 Ne Main St, Bethany Alf, Vidalia, GA 30474 | 2008-04-28 |
| 1871714600 | John Holmes Talton | Dentist | 316a Maple Drive, Vidalia, GA 30474 | 2007-05-01 |
| Find all providers in zip 30474 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629613468 | I Access Health, LLC | Family Medicine | 125 Church St Ste 200, Vidalia, GA 30474-4755 | 2019-11-15 |
| 1356829188 | Southeast Counseling Center LLC | Family Medicine | 506 1st Ave, Vidalia, GA 30474-3713 | 2018-08-02 |
| 1033314711 | Wheeler County Family Medicine | Family Medicine | 104 Maple Dr, Vidalia, GA 30474-8949 | 2007-06-20 |
| 1437100419 | Johnny Kevin Ingram | Family Medicine | 1154 Logan Sewell Dr, Vidalia, LA 71373-3342 | 2006-05-13 |
| 1740242023 | Melania B. Domingo | Family Medicine | 510 Maple Dr, Vidalia, GA 30474-8912 | 2006-04-04 |
| 1730157249 | Dennis A Laravia | Family Medicine | 900 Carter Street, Vidalia, LA 71373 | 2006-03-09 |
| 1346587755 | Joseph G Foust Md LLC | Family Medicine | 1811 Edwina Dr, Vidalia, GA 30474-8963 | 2013-01-07 |
| 1871761619 | J Kevin Ingram Medical, Inc | Family Medicine | 1806 Carter St, Vidalia, LA 71373-3115 | 2008-02-14 |
| 1780868760 | Natchez Regional Clinic | Family Medicine | 1806 Carter St, Vidalia, LA 71373-3115 | 2007-12-26 |
| 1649470410 | Southeast Ga Primary Prevent | Family Medicine | 1811 Edwina Dr, Vidalia, GA 30474-8963 | 2007-07-20 |
| Find all providers in VIDALIA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.