TATTNALL HOSPITAL COMPANY, LLC (NPI# 1588103592) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588103592 |
| Entity Type | Organization |
| Organization Name | TATTNALL HOSPITAL COMPANY, LLC |
| Other Organization Name | OPTIM MEDICAL CENTER- TATTNALL SOUTH BAXLEY |
| Practice Address |
821 S Main St Suite C Baxley GA 31513-0164 |
| Mailing Address |
460 Mall Blvd Suite B. Savannah GA 31406-4801 |
| Practice Telephone | 9127058040 |
| Practice Fax Number | 9126445260 |
| Mailing Telephone | 9126445300 |
| Mailing Fax Number | 9126443369 |
| Enumeration Date | 2017-02-23 |
| Last Update Date | 2017-02-23 |
| Authorized Official Name | DAVID CASTLEBERRY (CEO) |
| Authorized Official Telephone | 9126445300 |
| Is Organization Subpart | Y |
| Parent Organization Name | TATTNALL HOSPITAL COMPANY, LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2081P2900X |
Physical Medicine & Rehabilitation Specialization: Pain Medicine |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Optim Medical Center- Tattnall South Baxley | 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 |
| 1154614360 | Tattnall Hospital Company, LLC | Family Medicine | 1811 Edwina Drive, Vidalia, GA 30474 | 2011-05-20 |
| 1891009924 | Tattnall Hospital Company, LLC | Orthopaedic Surgery | 110 East Tollison Street, Baxley, GA 31513 | 2010-07-30 |
| Street Address |
821 S MAIN ST SUITE C |
| City | BAXLEY |
| State | GA |
| Zip Code | 31513-0164 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881228039 | Healthie Community Center LLC | Nurse Practitioner | 821 S Main St, Baxley, GA 31513-0164 | 2020-02-26 |
| 1134762750 | Jessica Audrey Covington | Nurse Practitioner | 821 S Main St, Baxley, GA 31513-0164 | 2019-10-27 |
| 1467992362 | Optim Orthopedics LLC | Physical Medicine & Rehabilitation | 821 S Main St, Suite C, Baxley, GA 31513-0164 | 2017-02-27 |
| 1306211529 | Optim Orthopedics, LLC | Orthopaedic Surgery | 821 S Main St, Suite C, Baxley, GA 31513-0164 | 2015-12-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033723515 | Sarah Chapman Swinson | Pharmacist | 160 Azalea Rd, Baxley, GA 31513 | 2020-09-02 |
| 1225642705 | Briana Baxley Aycock | Pharmacist | 160 Azalea Road, Baxley, GA 31513 | 2020-09-02 |
| 1114493988 | Telehealth Resources, LLC | Family Medicine | 77 North Main Street, Suite B, Baxley, GA 31513 | 2018-10-19 |
| 1588155386 | Jessica Jade Stone Lamb | Counselor | 7092 Nails Ferry Rd, Baxley, GA 31513 | 2018-05-29 |
| 1942701248 | The Baxley Appling County Hospital Authority | Family Medicine | 40 Wildes Street, Surrencey, GA 31513 | 2018-02-22 |
| 1023530953 | Dental Center of Baxley | Dentist | 51 Walnut Street, Baxley, GA 31513 | 2017-07-12 |
| 1083024608 | Mctwynn, Inc | Assisted Living Facility | 111 Stephens Ave, Baxley, GA 31513 | 2014-05-05 |
| 1801239389 | East Georgia Healthcare Center Inc | Clinic/Center | 1636 Hatch Parkway South, Baxley, GA 31513 | 2013-04-15 |
| 1093057101 | Bryan Lanier Holmes Sr. | Counselor | 185 Middlewood Dr., Baxley, GA 31513 | 2013-03-27 |
| 1821378076 | Doctors of Compassionate Services | Family Medicine | 277 Lackawanna St, Baxley, GA 31513 | 2011-08-19 |
| Find all providers in zip 31513 | ||||
| Taxonomy Code | 2081P2900X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Physical Medicine & Rehabilitation |
| Specialization | Pain Medicine |
| A physician who provides a high level of care, either as a primary physician or consultant, for patients experiencing problems with acute, chronic or cancer pain in both hospital and ambulatory settings. Patient care needs may also be coordinated with other specialists. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition changed, source changed] Additional Resources: American Board of Physical Medicine and Rehabilitation, 2007. http://www.abpmr.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Physical Medicine and Rehabilitation. A subspecialty certificate was approved by the ABMS in 1999. ACGME Accredited Residency Program Requirements: Proposal under development. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467992362 | Optim Orthopedics LLC | Physical Medicine & Rehabilitation | 821 S Main St, Suite C, Baxley, GA 31513-0164 | 2017-02-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700490091 | Interventional and Alternative Spine and Wellness, LLC | Physical Medicine & Rehabilitation | 3630 Wheeler Rd, Augusta, GA 30909-6561 | 2020-09-03 |
| 1881205151 | Georgia Regenrx, LLC. | Physical Medicine & Rehabilitation | 5755 N Point Pkwy Ste 72, Alpharetta, GA 30022-1146 | 2020-08-11 |
| 1710514989 | Jennifer Meyer | Physical Medicine & Rehabilitation | 1554 Riverstone Pkwy Ste 160, Canton, GA 30114-2887 | 2020-03-26 |
| 1982172060 | Back To Life Pain Center, LLC | Physical Medicine & Rehabilitation | 410 Creekstone Rdg, Woodstock, GA 30188-3740 | 2018-11-07 |
| 1760900708 | Neuro Diagnostic Group LLC | Physical Medicine & Rehabilitation | 200 Galleria Pkwy Se Ste 100, Atlanta, GA 30339-5944 | 2017-08-30 |
| 1386195378 | Pain Management and Rehabilitation | Physical Medicine & Rehabilitation | 4121 Steve Reynolds Blvd, Norcross, GA 30093-3060 | 2016-10-14 |
| 1124471172 | Pain Management and Rehabilitation | Physical Medicine & Rehabilitation | 4131 Steve Reynolds Blvd, Norcross, GA 30093-3060 | 2016-07-14 |
| 1043671761 | Pain Management and Rehabilitation Inc | Physical Medicine & Rehabilitation | 3955 Lawrenceville Hwy Nw, Lilburn, GA 30047-2996 | 2016-03-08 |
| 1356761191 | Simon Matt Willis | Physical Medicine & Rehabilitation | 114 Canal St Ste 503, Pooler, GA 31322-4261 | 2014-04-20 |
| 1891139663 | Advanced Pain and Rahabilitation PC | Physical Medicine & Rehabilitation | 3030 Mcever Rd Ste 300, Gainesville, GA 30504-5538 | 2013-04-24 |
| Find all providers with the same taxonomy | ||||
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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.