VIDALIA CHILDREN'S CENTER LLC (NPI# 1679705115) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679705115 |
| Entity Type | Organization |
| Organization Name | VIDALIA CHILDREN'S CENTER LLC |
| Practice Address |
125 Church Street Vidalia GA 30474 |
| Mailing Address |
Po Box 407 Vidalia GA 30475-0407 |
| Practice Telephone | 9125388484 |
| Practice Fax Number | 9125388665 |
| Mailing Telephone | 9125388484 |
| Mailing Fax Number | 9125388665 |
| Enumeration Date | 2009-08-18 |
| Last Update Date | 2014-09-05 |
| Authorized Official Name | TONY M OSTEEN (CFO) |
| Authorized Official Telephone | 9125385314 |
| Authorized Official Credential | CFO |
| Is Organization Subpart | Y |
| Parent Organization Name | SOUTHEADT REGIONAL PRIMARY CARE CORPORATION |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | Allopathic & Osteopathic Physicians |
| Street Address |
125 CHURCH STREET |
| City | VIDALIA |
| State | GA |
| Zip Code | 30474 |
| 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 | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710015318 | David Alan Timm | Pediatrics | 1806 Carter St, Vidalia, LA 71373-3115 | 2007-03-02 |
| 1437218013 | Timothy Caron Horton | Pediatrics | 1702 Meadows Ln Ste A, Vidalia, GA 30474-7220 | 2006-12-08 |
| 1881787570 | James Stewart Gantt | Pediatrics | 1702-b Meadows Lane, Vidalia, GA 30474 | 2006-10-02 |
| 1598767857 | Caryn J. Masterman-smith | Pediatrics | 125 Church St, Vidalia, GA 30474-4770 | 2005-06-01 |
| 1790288413 | Southeast Regional Primary Care Corporation | Pediatrics | 125 Church St, Vidalia, GA 30474-4770 | 2018-03-09 |
| 1326334384 | Lauren Courtney Miller | Pediatrics | 125 Church St, Vidalia, GA 30474-4770 | 2011-06-28 |
| 1447565635 | Marjorie Pringle Turner | Pediatrics | 125 Church St, Vidalia, GA 30474-4770 | 2010-08-11 |
| 1154554392 | Chelsea Boston Tehan | Pediatrics | 125 Church St, Vidalia, GA 30474-4770 | 2009-09-03 |
| 1417184771 | Katrina Mcclane Leshanski | Pediatrics | 125 Church St, Vidalia, GA 30474-4770 | 2009-06-14 |
| 1720134166 | Swayamprabha S Tyagi | Pediatrics | 414 Lugenia Dr, Vidalia, GA 30474-7210 | 2007-01-26 |
| 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.