INTEGRATED TELEHEALTH LLC (NPI# 1699299842) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1699299842 |
| Entity Type | Organization |
| Organization Name | INTEGRATED TELEHEALTH LLC |
| Practice Address |
1523 Old Valdosta Rd Ste B Ray City GA 31645 |
| Mailing Address |
1523 Old Valdosta Rd Ste B Ray City GA 31645-7132 |
| Practice Telephone | 8775437221 |
| Practice Fax Number | 8777552212 |
| Mailing Telephone | 8775437221 |
| Mailing Fax Number | 8777552212 |
| Enumeration Date | 2017-07-31 |
| Last Update Date | 2018-08-16 |
| Authorized Official Name | DR. JON C GIBBS (DIRECTOR) |
| Authorized Official Telephone | 7068310204 |
| Authorized Official Credential | MD |
| Is Organization Subpart | Y |
| Parent Organization Name | INTEGRATED TELEHEALTH LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians | ||
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SC | G38493 | 05 | |
| GA | 000616624F | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 342 Tifton Worth County Line Rd Ste 140, Tifton, GA 317935125 | 4784491255 | 4044812078 |
| Street Address |
1523 OLD VALDOSTA RD STE B |
| City | RAY CITY |
| State | GA |
| Zip Code | 31645 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861027930 | Deborah A Mceady | Contractor | 71 Thigpen Circle, Ray City, GA 31645 | 2020-03-09 |
| 1548604630 | Ashley Renee Michaels | Behavioral Analyst | 6 W Stanley Rd Ext, Ray City, GA 31645 | 2013-04-19 |
| 1972047140 | Billy Jacobs Jr. | Contractor | 40 Street D, Ray City, GA 31645-2071 | 2016-12-07 |
| 1356828925 | Southern Nutrition and Wellness | Dietitian, Registered | 6073 Luke Rd, Ray City, GA 31645-2119 | 2018-07-25 |
| 1710462114 | Lindsey L Jordan | Dietitian, Registered | 6073 Luke Rd, Ray City, GA 31645-2119 | 2018-10-02 |
| 1619452018 | Kati Wise | Dietitian, Registered | 6073 Luke Rd, Ray City, GA 31645-2119 | 2018-10-02 |
| 1336635507 | Lacee Nicole Jessup | Contractor | 215 Zeigler Rd, Ray City, GA 31645-6627 | 2018-07-10 |
| 1851917553 | Garland Edward Pendergraph | Pathology | 1974 Old Valdosta Rd, Ray City, GA 31645-7139 | 2020-06-19 |
| 1629313267 | Joyce Ann Deberry | Social Worker | 178 Highway 125, Ray City, GA 31645-7535 | 2012-12-08 |
| 1073859294 | Miranda Moneke Robinson | Social Worker | 95 Oak St, Ray City, GA 31645-8437 | 2012-12-15 |
| Find all providers in zip 31645 | ||||
| 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. |
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| 1124629365 | Dima Healthcare, Inc | Family Medicine | 7768 Cumming Hwy Ste 300, Canton, GA 30115-2982 | 2020-11-04 |
| 1871192260 | Ashley Willingham | Family Medicine | 210 Carlisle Way, Savannah, GA 31419-6606 | 2020-10-18 |
| 1831706217 | Veronica Vante | Family Medicine | 200 Business Center Dr Ste 204, Stockbridge, GA 30281-9025 | 2020-09-29 |
| 1912514969 | Oasis Healthcare Service | Family Medicine | 2195 Pace St Ste E, Covington, GA 30014-6657 | 2020-09-24 |
| 1881200772 | My Nurse Now, LLC | Family Medicine | 7070 Hodgson Memorial Dr, Savannah, GA 31406-2529 | 2020-09-16 |
| 1598377319 | Renee Green Lewis | Family Medicine | 9 Bluelake Blvd, Pooler, GA 31322-9617 | 2020-08-21 |
| 1841800836 | Ascend Medical Georgia PC | Family Medicine | One Alliance Center, 3500 Lenox Road Suite 1500, Atlanta, GA 30326 | 2020-08-04 |
| 1407464084 | Railyard Family Medicine LLC | Family Medicine | 416 Grayson Pkwy, Grayson, GA 30017-1220 | 2020-07-20 |
| 1851909535 | Newly Sought After International LLC | Family Medicine | 11815 Northfall Ln Ste 1001, Alpharetta, GA 30009-7973 | 2020-07-17 |
| 1992323398 | Careperks LLC | Family Medicine | 4936 Presidents Way, Tucker, GA 30084-3038 | 2020-07-12 |
| 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.