JANE BLALOCK (NPI# 1942572169) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1942572169 |
| Entity Type | Organization |
| Organization Name | JANE BLALOCK |
| Practice Address |
709 Carswell Ave Waycross GA 31501-4756 |
| Mailing Address |
1007 Mary St Waycross GA 31503-3823 |
| Practice Telephone | 9122835184 |
| Practice Fax Number | 9124497060 |
| Mailing Telephone | 9124497111 |
| Mailing Fax Number | 9124497060 |
| Enumeration Date | 2012-02-03 |
| Last Update Date | 2012-02-03 |
| Authorized Official Name | BOBBY BROWN (CEO) |
| Authorized Official Telephone | 9124497111 |
| Is Organization Subpart | Y |
| Parent Organization Name | SATILLA COMMUNITY SERVICES |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251S00000X | Community/Behavioral Health | Agencies |
| Street Address |
709 CARSWELL AVE |
| City | WAYCROSS |
| State | GA |
| Zip Code | 31501-4756 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962906115 | Davenport Health Pa | Family Medicine | 1401 Cherokee Drive, Waycross, GA 31501 | 2018-03-22 |
| 1962940478 | Blake Darren Aldridge | Physical Therapy Assistant | 401 Preston Street, Waycross, GA 31501 | 2017-02-03 |
| 1669922142 | Jebediah S. Christy Dds - Waycross Pllc | Dentist | 2271 Memorial Dr, Waycross, GA 31501 | 2016-10-10 |
| 1558721944 | Jana Kirby | Massage Therapist | 1599 Knight Ave., Kallman Chiropractic Center, Waycross, GA 31501 | 2016-02-29 |
| 1962877001 | Courtney Baldwin | Specialist/Technologist, Other | 2403 Spurgeon St, Waycross, GA 31501 | 2015-12-01 |
| 1912389784 | Grayson Stuart Griffis | Dentist | 2103 Tebeau St., Waycross, GA 31501 | 2015-06-29 |
| 1730561267 | Trishla Amit Desai | Internal Medicine | Memorial Satilla Health, 1900 Tebeau Street, Waycross, GA 31501 | 2015-06-20 |
| 1316330913 | Hanger Prosthetics & Orthotics, Inc. | Prosthetic/Orthotic Supplier | 512 City Blvd Ste H, Waycross, GA 31501 | 2015-03-06 |
| 1942699079 | Jose Ramon Martinez | Anesthesiology | 701 City Blvd, Waycross, GA 31501 | 2015-01-13 |
| 1023356714 | Orthopedics Surgeons of Georgia, LLC | Orthopaedic Surgery | 2015 Alice Street, Waycross, GA 31501 | 2013-01-30 |
| Find all providers in zip 31501 | ||||
| Taxonomy Code | 251S00000X |
| Grouping | Agencies |
| Classification | Community/Behavioral Health |
| A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, mental retardation, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. |
| Notes: Source: National Medicaid EDI HIPAA NPI Sub Work Group [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699185108 | Integral Care Network, LLC | Community/Behavioral Health | 200 N Nicholls St, Waycross, GA 31502-1344 | 2014-05-06 |
| 1841626140 | Garden Gate | Community/Behavioral Health | 852 Tiffany Ln, Waycross, GA 31503-0155 | 2013-09-18 |
| 1730454760 | Thomastine Mcgill | Community/Behavioral Health | 201 N Crawford St, Waycross, GA 31503-3932 | 2012-03-08 |
| 1851663074 | Ernestine Nelson | Community/Behavioral Health | 701 Reed St, Waycross, GA 31501-2931 | 2012-02-03 |
| 1750653978 | Flora Brown | Community/Behavioral Health | 821 Cedar St, Waycross, GA 31501-6410 | 2012-02-03 |
| 1881966018 | Christine Smith | Community/Behavioral Health | 908 Cedar St, Waycross, GA 31501-6440 | 2012-02-03 |
| 1225300452 | Supportive Employment | Community/Behavioral Health | 201 Brunel St, Waycross, GA 31501-2216 | 2012-02-03 |
| 1023380243 | Yvonne Thomas | Community/Behavioral Health | 606 Crescent St, Waycross, GA 31501-6321 | 2012-02-03 |
| 1770855868 | Bertha Richardsaon | Community/Behavioral Health | 1614 Carswell Ave, Waycross, GA 31503 | 2012-02-03 |
| 1417229188 | Ware Cs Now | Community/Behavioral Health | 3201 Harris Rd, Waycross, GA 31503-8956 | 2012-01-27 |
| Find all providers in WAYCROSS | ||||
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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.