JOHN W DEVINE, MD, PC (NPI# 1225245798) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1225245798 |
Entity Type | Organization |
Organization Name | JOHN W DEVINE, MD, PC |
Practice Address |
209 Pendleton Dr Valdosta GA 31602-1729 |
Mailing Address |
Po Box 162055 Atlanta GA 30321-2055 |
Practice Telephone | 2292594602 |
Practice Fax Number | 2292495063 |
Mailing Telephone | 2292594602 |
Mailing Fax Number | 2292495063 |
Enumeration Date | 2007-05-16 |
Last Update Date | 2020-04-14 |
Authorized Official Name | JOHN W DEVINE (OWNER) |
Authorized Official Telephone | 2292594602 |
Authorized Official Credential | MD |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 2085R0001X |
Radiology Specialization: Radiation Oncology |
027048 | GA | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
GA | BCBS | 235533 | 01 |
FL | 268851400 | 05 | |
GA | 332092 | 05 | |
GA | 000311066A | 05 |
Street Address |
209 PENDLETON DR |
City | VALDOSTA |
State | GA |
Zip Code | 31602-1729 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1649641721 | South Georgia Medical Center | General Acute Care Hospital | 209 Pendleton Dr, Valdosta, GA 31602-1729 | 2015-10-14 |
1003096009 | Eric Anderson Mdpc | Internal Medicine | 209 Pendleton Dr, Valdosta, GA 31602-1729 | 2007-11-07 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1477198117 | Amber Michele Baugh | Behavior Technician | 2236 Bemiss Road, Valdosta, GA 31602 | 2019-11-15 |
1528611365 | Nishaben T. Patel | Nurse Practitioner | 3120 North Oak Street Extension, Suite B, Valdosta, GA 31602 | 2019-07-22 |
1427615871 | Blair Elizabeth Tomlinson | Nurse Practitioner | 2124 Lakeshore Drive, Valdosta, GA 31602 | 2019-05-21 |
1346704152 | Mildred Itaska Borowski | Counselor | 3790 North Highway 41, Suite A, Valdosta, GA 31602 | 2019-01-25 |
1962991703 | Southern Healthcare Alliance, LLC | Physical Medicine & Rehabilitation | 101-f W. Northside Drive, Valdosta, GA 31602 | 2018-05-08 |
1336636646 | Kaitlyn Thrift | Behavioral Analyst | 2225 Bemiss Road Suite D, Valdosta, GA 31602 | 2018-04-23 |
1407379845 | Lindsey Marie Richardson | Dentist | 103 W. Cranford Ave, Valdosta, GA 31602 | 2017-07-18 |
1962922427 | Taylor Nicole Fiveash | Nurse Practitioner | 101 W Northisde Dr, Bldg G, Valdosta, GA 31602 | 2017-06-26 |
1720520646 | Southern Sleepers Anesthesia LLC | Nurse Anesthetist, Certified Registered | 4120-b N. Valdosta Road, Valdosta, GA 31602 | 2016-11-09 |
1134670557 | Cataract and Laser Surgery Center of South Georgia, P.C. | Clinic/Center | 4120-b N. Valdosta Rd., Valdosta, GA 31602 | 2016-10-20 |
Find all providers in zip 31602 |
Taxonomy Code | 2085R0001X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Radiology |
Specialization | Radiation Oncology |
A radiologist who deals with the therapeutic applications of radiant energy and its modifiers and the study and management of disease, especially malignant tumors. |
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1679199392 | Southern Rad Onc LLC | Radiology | 809 South Park Street, Carrollton, GA 30117 | 2020-06-18 |
1962910679 | American Professional Associates LLC | Radiology | 33 Upper Riverdale Rd Sw Ste 105, Riverdale, GA 30274-2642 | 2018-01-16 |
1003324187 | American Professional Associates LLC | Radiology | 1136 Cleveland Ave Ste 119, East Point, GA 30344-3618 | 2018-01-11 |
1316387137 | Rakendu Prakash Shukla | Radiology | 148 Bill Carruth Pkwy Ste Ll30, Hiram, GA 30141-3768 | 2013-06-25 |
1023301082 | Jolinta Lin | Radiology | The Emory Clinic Dept of Radiation Oncology, 1365 Clifton Road, Ne, Atlanta, GA 30322-0001 | 2011-05-25 |
1679739825 | Charles Reginald Woods IIi | Radiology | 275 Professional Ct, Suite B, Riverdale, GA 30274-2531 | 2008-08-06 |
1003086216 | Coastal Radiation Oncology Assoc. | Radiology | 2500 Starling St Ste 107, Brunswick, GA 31520-4266 | 2008-03-04 |
1275710899 | Shannon Tucker Kahn | Radiology | 639 Kimberly Ln Ne, Atlanta, GA 30306-2224 | 2008-01-25 |
1295924801 | Brian Wise Weaver | Radiology | 1355 Heatherland Dr Sw, Atlanta, GA 30331-7460 | 2007-10-19 |
1356475131 | Winburn Jackson Dickens | Radiology | 152 Monroe Hwy, Winder, GA 30680-0664 | 2007-03-15 |
Find all providers with the same taxonomy |
Please comment or provide details below to improve the information on JOHN W DEVINE, MD, PC.
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.