Jae Yoon Shin (NPI# 1396088803, PAC ID# 2163793415) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is PODIATRY.
| Nation Provider ID (NPI) | 1396088803 |
| PAC ID by PECOS | 2163793415 |
| Professional Enrollment ID | I20170803003235 |
| Full Name | Jae Yoon Shin |
| Organization Legal Name | FOOT AND ANKLE CENTER OF MIDDLE GEORGIA, LLC |
| Address |
1030 Peach Pkwy Suite 1 Fort Valley GA 31030-8191 |
| Phone Number | 4789884676 |
| Gender | M |
| Medical School | TEMPLE UNIVERSITY SCHOOL OF MEDICINE |
| Graduation Year | 2013 |
| Primary Specialty | PODIATRY |
| Group Practice PAC ID | 6204947609 |
| Number of Group Practice Members | 2 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 110069 | HOUSTON MEDICAL CENTER |
| 111310 | MEDICAL CENTER OF PEACH COUNTY, NAVICENT HEALTH |
| Address | Phone | Organization |
|---|---|---|
| 1030 Peach Pkwy, Suite 1, Fort Valley, GA 31030-8191 | 4789884676 | FOOT AND ANKLE CENTER OF MIDDLE GEORGIA, LLC |
| 1040 Morningside Dr, Perry, GA 31069-2904 | 4789884676 | FOOT AND ANKLE CENTER OF MIDDLE GEORGIA, LLC |
| Organization Legal Name | FOOT AND ANKLE CENTER OF MIDDLE GEORGIA, LLC |
| Physicians | 2 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Sarvepall D Jokhai | Podiatry | Foot and Ankle Center of Middle Georgia, LLC | 1040 Morningside Dr, Perry, GA 31069-2904 |
| Street Address |
1030 PEACH PKWY SUITE 1 |
| City | FORT VALLEY |
| State | GA |
| Zip | 31030-8191 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Cynthia L Giles | Family Medicine | 555 Blue Bird Blvd, Fort Valley, GA 31030 | |
| Nadia Mar Ramirez | Chiropractic | 204 N Camellia Blvd, Fort Valley, GA 31030-3005 | |
| Kimathi S.r. Blackwood | Nephrology | Central Georgia Kidney Specialists, PC | 135 Avera Dr, Fort Valley, GA 31030-5007 |
| Chukwuemeka Nwabuebo | Cardiovascular Disease (cardiology) | Georgia Heart Physicians LLC | 105 Avera Dr, Fort Valley, GA 31030-5007 |
| Claudia A Clarke | Nurse Practitioner | Georgia Heart Physicians LLC | 105 Avera Dr, Fort Valley, GA 31030-5007 |
| Saghir Ahmed | Nephrology | Central Georgia Kidney Specialists, PC | 135 Avera Dr, Fort Valley, GA 31030-5007 |
| Juanita Lynn Knowles | Nurse Practitioner | Central Georgia Kidney Specialists, PC | 135 Avera Dr, Fort Valley, GA 31030-5007 |
| Michael W Early Sr. | Family Medicine | 201 Avera Dr, Fort Valley, GA 31030-5008 | |
| John G Hawkins | Cardiovascular Disease (cardiology) | The Corporation of Mercer University | 201 Avera Dr, Fort Valley, GA 31030-5008 |
| Crystal L Brown | Family Medicine | 701 Bluebird Blvd, Fort Valley, GA 31030-5085 | |
| Find all physicians in zip 31030 | |||
| City | FORT VALLEY |
| Zip Code | 31030 |
| Specialty | PODIATRY |
| City + Specialty | FORT VALLEY + PODIATRY |
Please comment or provide details below to improve the information on Jae Yoon Shin.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.