DR. MATTHEW DEMORE III (NPI# 1659378750) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1659378750 |
| Entity Type | Individual |
| Full Name | DR. MATTHEW DEMORE III |
| Credential | D.P.M. |
| Practice Address |
1707 Meadows Ln Suite H Vidalia GA 30474-7200 |
| Mailing Address |
Po Box 407 Vidalia GA 30475-0407 |
| Practice Telephone | 9125380040 |
| Practice Fax Number | 9125387070 |
| Mailing Telephone | 9125380040 |
| Mailing Fax Number | 9125387070 |
| Enumeration Date | 2005-07-05 |
| Last Update Date | 2016-12-26 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 213ES0103X |
Podiatrist Specialization: Foot & Ankle Surgery |
POD001325 | GA | Podiatric Medicine & Surgery Service Providers |
| N | 213ES0103X |
Podiatrist Specialization: Foot & Ankle Surgery |
36-002649D | OH | Podiatric Medicine & Surgery Service Providers |
| Street Address |
1707 MEADOWS LN SUITE H |
| City | VIDALIA |
| State | GA |
| Zip Code | 30474-7200 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932333291 | Amber Nobles Joyner | Nurse Practitioner | 1707 Meadows Ln, Suite C, Vidalia, GA 30474-7200 | 2009-05-14 |
| 1134367550 | Vidalia Orthopedic Center, LLC | Orthopaedic Surgery | 1707 Meadows Ln, Suite H, Vidalia, GA 30474-7200 | 2009-01-22 |
| 1063659225 | Martina Vendrame | Neuromusculoskeletal Medicine & OMM | 1707 Meadows Ln, Suite A, Vidalia, GA 30474-7200 | 2009-01-09 |
| 1417115817 | Vidalia Regional Cancer Center | Internal Medicine | 1707 Meadows Ln, Suite C, Vidalia, GA 30474-7200 | 2008-06-02 |
| 1760664270 | South Georgia Pulmonary, Critical Care and Sleep Medicine | Internal Medicine | 1707 Meadows Ln, Suite E, Vidalia, GA 30474-7200 | 2007-11-27 |
| 1205058948 | Bartlett Emory Davis | Specialist/Technologist | 1707 Meadows Ln, Suite H, Vidalia, GA 30474-7200 | 2007-05-03 |
| 1093887820 | Robert Eugene Johnson | Otolaryngology | 1707 Meadows Ln, Suite C, Vidalia, GA 30474-7200 | 2006-11-15 |
| 1184670036 | Ronald W Williams Jr. | Otolaryngology | 1707 Meadows Ln, Suite C, Vidalia, GA 30474-7200 | 2006-05-25 |
| 1114915618 | James W. Fordyce | Orthopaedic Surgery | 1707 Meadows Ln, Suite H, Vidalia, GA 30474-7200 | 2005-10-10 |
| 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 | 213ES0103X |
| Grouping | Podiatric Medicine & Surgery Service Providers |
| Classification | Podiatrist |
| Specialization | Foot & Ankle Surgery |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437652815 | Southeast Regional Primary Care Corporation | Podiatrist | 1707 Meadows Ln Ste H, Vidalia, GA 30474-7201 | 2018-03-13 |
| 1477535474 | Gregory Mark Wiggins | Podiatrist | 205 Arlington Dr, Vidalia, GA 30474-7209 | 2005-11-16 |
| 1104030824 | Wiggins Foot and Ankle Associates P.C. | Podiatrist | 205 Arlington Dr, Vidalia, GA 30474-7209 | 2007-05-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518515980 | Da Vinci Foot and Ankle Madison LLC | Podiatrist | 1740 Lions Club Rd Ste 200, Madison, GA 30650-4762 | 2019-08-29 |
| 1376191106 | Ryan Goldfine Dpm LLC | Podiatrist | 3451 Ernest W Barrett Pkwy Suite 170, Mariettta, GA 30269 | 2019-08-26 |
| 1073076170 | Kalish Foot & Ankle Institute | Podiatrist | 6911 Tara Blvd Ste 101, Jonesboro, GA 30236-1503 | 2019-04-08 |
| 1427523919 | Tommy Lee Tally | Podiatrist | 8225 Mall Pkwy Ste 230, Lithonia, GA 30038-6913 | 2018-10-10 |
| 1881188944 | Joshua Jae Lee | Podiatrist | 3425 Buford Dr Ste 350, Buford, GA 30519-8785 | 2018-06-21 |
| 1447762927 | Ponders Podiatry LLC | Podiatrist | 275 Carpenter Drive Ne, Suite 106, Atlanta, GA 30328 | 2017-10-24 |
| 1194245894 | Yusuf Abiodun Opakunle | Podiatrist | 600 Professional Dr Ste 130, Lawrenceville, GA 30046-7638 | 2017-06-23 |
| 1891228540 | Vishal Patel | Podiatrist | 755 Mount Vernon Hwy Ne Ste 210, Atlanta, GA 30328-4279 | 2017-04-10 |
| 1497296552 | Ankle and Foot Assoc, LLC | Podiatrist | 118 Azalea Rd, Suite 1-2, Baxley, GA 31513-0672 | 2017-03-09 |
| 1245770437 | Ankle and Foot Assoc, LLC | Podiatrist | 94 Andrews Way, Saint Marys, GA 31558-1632 | 2017-03-07 |
| 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.