WALLEY CLINIC PA (NPI# 1669463584) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669463584 |
| Entity Type | Organization |
| Organization Name | WALLEY CLINIC PA |
| Practice Address |
920 Matthew Dr Ste A Waynesboro MS 39367-2567 |
| Practice Telephone | 6017352401 |
| Practice Fax Number | 6017355205 |
| Mailing Telephone | 6017352401 |
| Mailing Fax Number | 6017355205 |
| Enumeration Date | 2005-10-31 |
| Last Update Date | 2008-02-27 |
| Authorized Official Name | ELETHA JANE JENKINS (CEO) |
| Authorized Official Telephone | 6017352401 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 09011779 | 05 |
| Street Address |
920 MATTHEW DR STE A |
| City | WAYNESBORO |
| State | MS |
| Zip Code | 39367-2567 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114353539 | South Central Regional Medical Center | Dermatology | 920 Matthew Dr, Suite 8, Waynesboro, MS 39367-2553 | 2013-09-17 |
| 1598787160 | Wayne General Hospital | Home Health | 920 Matthew Dr, Suite 2, Waynesboro, MS 39367-2553 | 2006-07-24 |
| 1215958780 | Wayne General Hospital | Hospice Care, Community Based | 920 Matthew Dr, Suite2, Waynesboro, MS 39367-2553 | 2006-07-21 |
| 1295765022 | Thomas Casey Woodring | Obstetrics & Gynecology | 920 Matthew Dr, Suite A, Waynesboro, MS 39367-2553 | 2006-07-04 |
| 1316988025 | Wayne General Hospital | Clinic/Center | 920 Matthew Dr, Ste D, Waynesboro, MS 39367 | 2006-06-10 |
| 1356310536 | Jatinder Singh | Internal Medicine | 920 Matthew Dr, Waynesboro, MS 39367-2553 | 2006-03-17 |
| 1114995537 | Wulf Hirschfield | Internal Medicine | 920 Matthew Dr, Suite D, Waynesboro, MS 39367-2553 | 2006-03-10 |
| 1093798266 | Cynthia C. Odom | Nurse Practitioner | 920 Matthew Dr, Waynesboro, MS 39367-2553 | 2005-11-22 |
| 1043201858 | William Edwin Powell | Family Medicine | 920 Matthew Dr, Ste A, Waynesboro, MS 39367-2567 | 2005-11-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275056541 | Helping Hand Home Care LLC | Respite Care | 822a Station St., Waynesboro, MS 39367 | 2017-07-19 |
| 1578914339 | Megan Cook | Specialist/Technologist | 44 D Hutto Drive, Waynesboro, MS 39367 | 2016-06-23 |
| 1932413762 | Bendan Boyd | Nurse Practitioner | 501 Azalea Dr. Suite F, Waynesboro, MS 39367 | 2010-08-04 |
| 1912181868 | Terry G Agent | Physical Therapist | 44 Old Highway 45 Loop Road, Waynesboro, MS 39367 | 2007-12-27 |
| 1265631949 | Joseph Daniel Stringer Jr. | Dentist | 803 Mississippi Drive, Waynesboro, MS 39367 | 2007-07-13 |
| 1245313014 | Wal-mart Stores East, Lp | Technician/Technologist | 1350 Azalea Drive, Waynesboro, MS 39367 | 2006-10-23 |
| 1851488514 | Charles Todd Stokley | Family Medicine | 940 Matthew Drive, Suite 2, Waynesboro, MS 39367 | 2006-10-06 |
| 1396832150 | William Daniel Young | Specialist | 940 Matthew Dr Ste 7, Waynesboro, MS 39367 | 2006-10-05 |
| 1518076546 | Family Dental Center of Waynesboro, P.a. | Dentist | 500 Court Street, Waynesboro, MS 39367 | 2006-08-30 |
| 1780624510 | Bobbie Jean Cooksey | Nurse Practitioner | 920 Matthew Drive, Suite D, Waynesboro, MS 39367 | 2006-06-08 |
| Find all providers in zip 39367 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730511858 | Amg Crockett LLC | Family Medicine | 550 Highway 64 E, Hurricane Plaza Suite 4, Waynesboro, TN 38485-3037 | 2013-07-31 |
| 1578909347 | Kristamarie F Collman | Family Medicine | 201 Lew Dewitt Blvd Ste A, Waynesboro, VA 22980 | 2013-05-20 |
| 1275762320 | Arthur Eugene Wood Iv | Family Medicine | 920 Matthew Dr Ste D, Waynesboro, MS 39367-2553 | 2009-07-10 |
| 1285882662 | Wayne General Hospital | Family Medicine | 951 Matthew Dr Ste A, Waynesboro, MS 39367-2566 | 2008-08-28 |
| 1184814519 | Bonnie P Jenkins Md PC | Family Medicine | 201 Dogwood Drive, Waynesboro, GA 30830 | 2007-08-01 |
| 1477760122 | David Barclay Walthall IIi | Family Medicine | 541 Walnut Ave, Waynesboro, VA 22980 | 2007-05-16 |
| 1184842551 | Laura Jean Brand | Family Medicine | 2014 Goose Creek Rd, Suite 106, Waynesboro, VA 22980-6588 | 2007-04-23 |
| 1851488514 | Charles Todd Stokley | Family Medicine | 940 Matthew Drive, Suite 2, Waynesboro, MS 39367 | 2006-10-06 |
| 1023110392 | Joe I Hall Md PC | Family Medicine | 107 J V Mangubat Drive, Waynesboro, TN 38485-2440 | 2006-09-05 |
| 1861432916 | Bonnie P Jenkins | Family Medicine | 201 Dogwood Dr, Waynesboro, GA 30830-5445 | 2006-06-07 |
| Find all providers in WAYNESBORO | ||||
| City | WAYNESBORO |
| Zip Code | 39367 |
Please comment or provide details below to improve the information on WALLEY CLINIC PA.
| 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.