VPC INC (NPI# 1710043237) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710043237 |
| Entity Type | Organization |
| Organization Name | VPC INC |
| Other Organization Name | VIDALIA PEDIATRIC CLINIC |
| Practice Address |
414 Lugenia Dr Vidalia GA 30474-7210 |
| Mailing Address |
303 Harris Industrial Blvd Ste 3 Vidalia GA 30474-8854 |
| Practice Telephone | 9125379355 |
| Practice Fax Number | 9125377038 |
| Mailing Telephone | 9125379355 |
| Mailing Fax Number | 9123354804 |
| Enumeration Date | 2006-12-29 |
| Last Update Date | 2019-05-20 |
| Authorized Official Name | JO E SMITH (PRESIDENT PRACTICE MGR) |
| Authorized Official Telephone | 9125379355 |
| Authorized Official Credential | CMM |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QR1300X |
Clinic/Center Specialization: Rural Health |
Ambulatory Health Care Facilities | ||
| Y | 208000000X | Pediatrics | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Vidalia Pediatric Clinic | Doing Business As Name - Organization |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Virginia Business Entities | VPC Inc. | 240 Business Center Dr, Reisterstown, Maryland 21136 |
| Street Address |
414 LUGENIA DR |
| City | VIDALIA |
| State | GA |
| Zip Code | 30474-7210 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194290338 | Kelly White Wall | Nurse Practitioner | 414 Lugenia Dr, Vidalia, GA 30474-7210 | 2018-10-03 |
| 1265883730 | Laura H White | Nurse Practitioner | 414 Lugenia Dr, Vidalia, GA 30474-7201 | 2016-06-27 |
| 1275919771 | Mary Minter | Nurse Practitioner | 414 Lugenia Dr, Vidalia, GA 30474-7210 | 2015-08-06 |
| 1124144688 | Angela Renae Baldy | Nurse Practitioner | 414 Lugenia Dr, Vidalia, GA 30474-7210 | 2007-03-22 |
| 1720134166 | Swayamprabha S Tyagi | Pediatrics | 414 Lugenia Dr, Vidalia, GA 30474-7210 | 2007-01-26 |
| 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 |
| 1679705115 | Vidalia Children's Center LLC | Pediatrics | 125 Church Street, Vidalia, GA 30474 | 2009-08-18 |
| 1417184771 | Katrina Mcclane Leshanski | Pediatrics | 125 Church St, Vidalia, GA 30474-4770 | 2009-06-14 |
| 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.