DR. MEREDITH UDELL (NPI# 1871768002) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871768002 |
| Entity Type | Individual |
| Full Name | DR. MEREDITH UDELL |
| Credential | MD |
| Practice Address |
11 Charlie Morris Rd Colbert GA 30628-2445 |
| Mailing Address |
Po Box 459 Colbert GA 30628-0459 |
| Practice Telephone | 7067882127 |
| Mailing Telephone | 7067882127 |
| Enumeration Date | 2008-04-29 |
| Last Update Date | 2016-08-29 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | 067451 | GA | Allopathic & Osteopathic Physicians |
| N | 208000000X | Pediatrics | 148900 | NC | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 5918073 | 05 | |
| GA | 003123988C | 05 | |
| SC | NC1447 | 05 |
| Street Address |
11 CHARLIE MORRIS RD |
| City | COLBERT |
| State | GA |
| Zip Code | 30628-2445 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588642771 | Nicole Ford | Nurse Practitioner | 11 Charlie Morris Rd, Colbert, GA 30628-2445 | 2006-01-06 |
| 1477176600 | Dallas Louis | Nurse Practitioner | 11 Charlie Morris Rd, Colbert, GA 30628-2445 | 2020-05-21 |
| 1144849233 | Sarah Sammons | Nurse Practitioner | 11 Charlie Morris Rd, Colbert, GA 30628-2445 | 2020-04-09 |
| 1174184030 | Evan Grovenstein | Nurse Practitioner | 11 Charlie Morris Rd, Colbert, GA 30628-2445 | 2019-06-21 |
| 1245732254 | Medlink Georgia Inc | Pharmacy | 11 Charlie Morris Rd, Colbert, GA 30628-2445 | 2018-03-06 |
| 1801248182 | Jordan Hoffman | Social Worker | 11 Charlie Morris Rd, Colbert, GA 30628-2445 | 2016-07-11 |
| 1720451222 | Candace Vandiver | Nurse Practitioner | 11 Charlie Morris Rd, Colbert, GA 30628-2445 | 2015-11-05 |
| 1295172773 | Matthew Davis | Family Medicine | 11 Charlie Morris Rd, Colbert, GA 30628-2445 | 2013-05-24 |
| 1336492503 | Nora Ann Blankenship | Social Worker | 11 Charlie Morris Rd, Colbert, GA 30628-2445 | 2012-10-24 |
| 1972897700 | Akilah S Tomingas | Pediatrics | 11 Charlie Morris Rd, Colbert, GA 30628 | 2011-06-09 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326173956 | Jonathan Marc Perry | Pharmacist | 15 Colbert Business Parkway, Fred's Pharmacy #1394, Colbert, GA 30628 | 2007-02-22 |
| 1366938086 | Preston Gantt, Md, Sa-c | Surgery | 191 Valley Rd, Colbert, GA 30628 | 2018-07-05 |
| 1902304538 | Preston Gantt | Surgery | 191 Valley Rd, Colbert, GA 30628 | 2018-01-29 |
| 1134559958 | Manuel Garcia-gaona | Physical Therapist | 19 Dogwood Dr, Colbert, GA 30628-1512 | 2013-11-14 |
| 1720353675 | Innovative Medical Group | Durable Medical Equipment & Medical Supplies | 232 Jeremy Dr, Colbert, GA 30628-1543 | 2012-03-11 |
| 1154399152 | Amanda Griffin Wagner | Psychologist | 11 Charlie Morris Rd Bldg 2, Colbert, GA 30628-2445 | 2006-03-08 |
| 1669951414 | Medlink Georgia Inc | Clinic/Center | 11 Charlie Morris Rd Bldg 2, Colbert, GA 30628-2445 | 2018-08-13 |
| 1033449665 | Freds Stores of Tennessee Inc | Durable Medical Equipment & Medical Supplies | 15 Colbert Business Pkwy W, Colbert, GA 30628-2462 | 2010-01-04 |
| 1104134469 | Southern Medical Transport | Non-emergency Medical Transport (VAN) | 276 Kincaid Cemetery Rd, Colbert, GA 30628-2547 | 2010-09-21 |
| 1447443361 | Robyn Cain Crouse | Physical Therapist | 1450 Old Kincaid Rd, Colbert, GA 30628-2559 | 2007-08-23 |
| Find all providers in zip 30628 | ||||
| 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 |
|---|---|---|---|---|
| 1972897700 | Akilah S Tomingas | Pediatrics | 11 Charlie Morris Rd, Colbert, GA 30628 | 2011-06-09 |
| 1851680938 | Kelly Pascual Montgomery | Pediatrics | 11 Charlie Morris Rd, Colbert, GA 30628 | 2011-03-29 |
| 1780900274 | Elizabeth Broman Long | Pediatrics | 11 Charlie Morris Rd, Colbert, GA 30628-2445 | 2010-04-09 |
| 1962513473 | Nakeshia L Brown | Pediatrics | 11 Charlie Morris Rd, Colbert, GA 30628-2445 | 2006-08-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063025690 | Sas Medical LLC | Pediatrics | 8601 Dunwoody Pl Ste 565, Sandy Springs, GA 30350-2519 | 2020-08-24 |
| 1467063248 | Kindercare Pediatrics of Georgia | Pediatrics | 174 Royal Oak Dr, Guyton, GA 31312-5624 | 2020-08-13 |
| 1649880667 | Grayson Pediatrics Mobile | Pediatrics | 297 Cooper Rd Ste B, Loganville, GA 30052-2518 | 2020-08-04 |
| 1134745953 | Molly C Shields | Pediatrics | Dugas Building Bg 107 1120 15th Street, Augusta, GA 30912-0001 | 2020-06-17 |
| 1033734918 | Lauren Wooten Smith | Pediatrics | Chog Pediatric Residency Program 1120 15th Street, Augusta, GA 30912-0001 | 2020-06-16 |
| 1225667314 | Moyosore Mary Abere | Pediatrics | 104 Bluff Chase, Bonaire, GA 31005-3867 | 2020-04-02 |
| 1447886155 | Natalie Brown Shumate | Pediatrics | 1669 Pleasant Valley Rd Ne, Monroe, GA 30655-6211 | 2020-03-14 |
| 1356988455 | Maura Mchugh Barrett | Pediatrics | 1805 Parke Plaza Cir Ste 103, Stone Mountain, GA 30087-3646 | 2019-12-08 |
| 1629614060 | Kaley Adams | Pediatrics | 227 Torrington Blvd, Thomasville, GA 31757-3904 | 2019-11-20 |
| 1164066791 | Holly Savino | Pediatrics | 603 Old Norcross Rd Ste A, Lawrenceville, GA 30046-4315 | 2019-11-06 |
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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.