GEORGIA REGENTS UNIVERSITY (NPI# 1255719621) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255719621 |
| Entity Type | Organization |
| Organization Name | GEORGIA REGENTS UNIVERSITY |
| Practice Address |
3259 Val Tech Rd Valdosta GA 31602-9309 |
| Mailing Address |
9444 Dry Lake Rd Quitman GA 31643-5925 |
| Practice Telephone | 2292494971 |
| Mailing Telephone | 2292635863 |
| Enumeration Date | 2015-05-18 |
| Last Update Date | 2015-05-18 |
| Authorized Official Name | DR. BILLY NICHOLS (STATEWIDE MEDICAL DIRECTOR) |
| Authorized Official Telephone | 2292494971 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251K00000X | Public Health or Welfare | RN179363 | GA | Agencies |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386065258 | Georgia Regents University | General Practice | 1120 15th St, Pavilion II, Af 1040, Augusta, GA 30912-0004 | 2013-12-19 |
| Street Address |
3259 VAL TECH RD |
| City | VALDOSTA |
| State | GA |
| Zip Code | 31602-9309 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972094134 | Valdosta State Prison Regional Pharmacy | Pharmacy | 3259 Val Tech Rd, Valdosta, GA 31602-9309 | 2018-05-23 |
| 1760920730 | Lavern Jackson Fry | Nurse Practitioner | 3259 Val Tech Rd, Valdosta, GA 31602-9309 | 2017-02-09 |
| 1164801460 | Georgia Correctional Health Care | Public Health or Welfare | 3259 Val Tech Rd, Valdosta, GA 31602-9309 | 2015-05-20 |
| 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 | 251K00000X |
| Grouping | Agencies |
| Classification | Public Health or Welfare |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487710927 | South Health District | Public Health or Welfare | 2700 N Oak St Bldg C, Valdosta, GA 31602-5904 | 2006-12-29 |
| 1215092283 | South Health District | Public Health or Welfare | 2700 N Oak St Bldg B, Valdosta, GA 31602-5903 | 2006-12-27 |
| 1154485027 | South Health District | Public Health or Welfare | 117 S Patterson St, Valdosta, GA 31601-5608 | 2006-12-21 |
| 1144320177 | South Health District 8-1 (infectious Disease Program) | Public Health or Welfare | 601 N Lee St, Valdosta, GA 31601-4725 | 2006-09-22 |
| 1164801460 | Georgia Correctional Health Care | Public Health or Welfare | 3259 Val Tech Rd, Valdosta, GA 31602-9309 | 2015-05-20 |
| 1366685307 | South Health District | Public Health or Welfare | 312 N Patterson St, Valdosta, GA 31601-5526 | 2009-04-07 |
| 1598821035 | South Health District | Public Health or Welfare | 2700 N Oak St Bldg B, Valdosta, GA 31602-5903 | 2006-12-29 |
| 1023174562 | South Health District | Public Health or Welfare | 312 N Patterson St, Valdosta, GA 31601-5526 | 2006-12-29 |
| 1760548200 | South Health District | Public Health or Welfare | 312 N Patterson St, Valdosta, GA 31601-5526 | 2006-12-29 |
| 1780749028 | South Health District | Public Health or Welfare | 601 N Lee St, Valdosta, GA 31601-4725 | 2006-12-27 |
| Find all providers in VALDOSTA | ||||
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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.