VIDALIA NEUROLOGY ASSOCIATES, LLC (NPI# 1316371792) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316371792 |
| Entity Type | Organization |
| Organization Name | VIDALIA NEUROLOGY ASSOCIATES, LLC |
| Practice Address |
1707 Meadows Lane Suite A Vidalia GA 30474-7200 |
| Mailing Address |
Po Box 407 Vidalia GA 30475-0407 |
| Practice Telephone | 9125379779 |
| Mailing Telephone | 9125374986 |
| Enumeration Date | 2013-08-21 |
| Last Update Date | 2014-09-05 |
| Authorized Official Name | TONY M OSTEEN (CFO) |
| Authorized Official Telephone | 9125385314 |
| Is Organization Subpart | Y |
| Parent Organization Name | SOUTHEAST PRIMARY CARE CORPORATION |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians |
| Street Address |
1707 MEADOWS LANE SUITE A |
| City | VIDALIA |
| State | GA |
| Zip Code | 30474-7200 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649338997 | John E Schoell | Internal Medicine | 1707 Meadows Lane, Suite E, Vidalia, GA 30474 | 2006-12-05 |
| 1689851198 | Vidalia Ent Associates, LLC | Otolaryngology | 1707 Meadows Lane, Suite C, Vidalia, GA 30474 | 2008-01-28 |
| 1437356359 | Vidalia Ob Gyn | Independent Medical Examiner | 1707 Meadows Lane, Vidalia, GA 30474 | 2007-07-03 |
| 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 |
| 1154614360 | Tattnall Hospital Company, LLC | Family Medicine | 1811 Edwina Drive, Vidalia, GA 30474 | 2011-05-20 |
| 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 |
| Find all providers in zip 30474 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952698532 | Kellen Travis Jex | Internal Medicine | 107 Front St Ste 2126, Vidalia, LA 71373 | 2011-07-05 |
| 1760793517 | Gary Joseph Laubacker Jr. | Internal Medicine | 621 E 1st St Ste B, Vidalia, GA 30474-4264 | 2010-06-27 |
| 1134358419 | Misty Denise Poole | Internal Medicine | 210 Mose Coleman Dr, Vidalia, GA 30474-8677 | 2009-07-08 |
| 1528264629 | Southeastern Cardiovascular Img, Inc. | Internal Medicine | 1006a Mount Vernon Rd, Vidalia, GA 30474-3029 | 2007-06-25 |
| 1700922069 | Ibrahim Seki | Internal Medicine | 1812 Carter St, Vidalia, LA 71373 | 2007-01-30 |
| 1902942220 | F. Geoffery Conner | Internal Medicine | 1608 Meadows Ln Ste 1, Vidalia, GA 30474-9907 | 2007-01-30 |
| 1750325452 | David Hansell Paine | Internal Medicine | 1006 A Mt.vernon Rd, Vidalia, GA 30474 | 2006-06-15 |
| 1447251996 | Iley Floyd Dillon | Internal Medicine | 107 Front St, Suite 2109, Vidalia, LA 71373-2836 | 2005-08-09 |
| 1063914851 | Southeast Regional Primary Care Corporation | Internal Medicine | 621 E 1st St Ste B, Vidalia, GA 30474-4264 | 2018-03-07 |
| 1003176546 | Misty D. Poole, Md, LLC | Internal Medicine | 210 Mose Coleman Dr, Vidalia, GA 30474-8677 | 2012-05-17 |
| 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.