SOUTHEAST REGIONAL PRIMARY CARE CORPORATION (NPI# 1134622517) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134622517 |
| Entity Type | Organization |
| Organization Name | SOUTHEAST REGIONAL PRIMARY CARE CORPORATION |
| Other Organization Name | MEADOWS MEDICAL GROUP ANESTHESIA |
| Practice Address |
1 Meadows Pkwy Vidalia GA 30474-8759 |
| Mailing Address |
Po Box 407 Vidalia GA 30475-0407 |
| Practice Telephone | 9125374986 |
| Enumeration Date | 2018-03-13 |
| Last Update Date | 2018-03-13 |
| Authorized Official Name | TONY M O'STEEN (CFO) |
| Authorized Official Telephone | 9125355560 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207L00000X | Anesthesiology | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Meadows Medical Group Anesthesia | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083117469 | Southeast Regional Primary Care Corporation | Otolaryngology | 1707 Meadows Ln Ste C, Vidalia, GA 30474-7201 | 2018-03-13 |
| 1437652815 | Southeast Regional Primary Care Corporation | Podiatrist | 1707 Meadows Ln Ste H, Vidalia, GA 30474-7201 | 2018-03-13 |
| 1225531197 | Southeast Regional Primary Care Corporation | Internal Medicine | 1811 Edwina Dr, Vidalia, GA 30474-8963 | 2018-03-16 |
| 1336642719 | Southeast Regional Primary Care Corporation | Internal Medicine | 101 Harris Industrial Blvd Ste A, Vidalia, GA 30474-8852 | 2018-03-13 |
| 1790288181 | Southeast Regional Primary Care Corporation | General Acute Care Hospital | 1 Meadows Pkwy, Vidalia, GA 30474-8759 | 2018-03-13 |
| 1053814434 | Southeast Regional Primary Care Corporation | Urology | 303 Harris Industrial Blvd Ste 5, Vidalia, GA 30474-8854 | 2018-03-13 |
| 1790288413 | Southeast Regional Primary Care Corporation | Pediatrics | 125 Church St, Vidalia, GA 30474-4770 | 2018-03-09 |
| 1619470333 | Southeast Regional Primary Care Corporation | Obstetrics & Gynecology | 101 Harris Industrial Blvd Ste C, Vidalia, GA 30474-8852 | 2018-03-09 |
| 1750883435 | Southeast Regional Primary Care Corporation | Internal Medicine | 104 Fairview Park Dr, Dublin, GA 31021-2500 | 2018-03-08 |
| 1063914851 | Southeast Regional Primary Care Corporation | Internal Medicine | 621 E 1st St Ste B, Vidalia, GA 30474-4264 | 2018-03-07 |
| Street Address |
1 MEADOWS PKWY |
| City | VIDALIA |
| State | GA |
| Zip Code | 30474-8759 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952393258 | Anthony D Mancuso | Anesthesiology | 1 Meadows Pkwy, Vidalia, GA 30474-8759 | 2005-08-22 |
| 1023668894 | Hunter Dennard Richman | Physician Assistant | 1 Meadows Pkwy, Vidalia, GA 30474-8759 | 2019-09-13 |
| 1841855285 | Steven Michael Lashley | Emergency Medicine | 1 Meadows Pkwy, Vidalia, GA 30474-8759 | 2019-05-01 |
| 1851856124 | Megan Mitchell Rivera-o'rourke | Nurse Practitioner | 1 Meadows Pkwy, Vidalia, GA 30474-8759 | 2019-01-31 |
| 1790288181 | Southeast Regional Primary Care Corporation | General Acute Care Hospital | 1 Meadows Pkwy, Vidalia, GA 30474-8759 | 2018-03-13 |
| 1275085508 | Daniel Hartley | Nurse Practitioner | 1 Meadows Pkwy, Vidalia, GA 30474-8759 | 2016-11-03 |
| 1487004230 | Glen Jason Bunn Jr. | Emergency Medicine | 1 Meadows Pkwy, Vidalia, GA 30474-8759 | 2016-06-13 |
| 1962873711 | Leah M Waller | Physician Assistant | 1 Meadows Pkwy, Vidalia, GA 30474-8759 | 2015-10-19 |
| 1396116414 | Meadows Anesthesia LLC | Anesthesiology | 1 Meadows Pkwy, Vidalia, GA 30474-8759 | 2015-10-15 |
| 1528447372 | Christina Michelle Tidwell | Physician Assistant | 1 Meadows Pkwy, Vidalia, GA 30474-8759 | 2015-05-27 |
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| 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 | 207L00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Anesthesiology |
| An anesthesiologist is trained to provide pain relief and maintenance, or restoration, of a stable condition during and immediately following an operation or an obstetric or diagnostic procedure. The anesthesiologist assesses the risk of the patient undergoing surgery and optimizes the patient's condition prior to, during and after surgery. In addition to these management responsibilities, the anesthesiologist provides medical management and consultation in pain management and critical care medicine. Anesthesiologists diagnose and treat acute, long-standing and cancer pain problems; diagnose and treat patients with critical illnesses or severe injuries; direct resuscitation in the care of patients with cardiac or respiratory emergencies, including the need for artificial ventilation; and supervise post-anesthesia recovery. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Anesthesiology, 2007. http://www.theaba.org/; American Osteopathic Board of Anesthesiology, 2007, http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Anesthesiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Anesthesiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912955725 | Vidalia Anesthesia Assoc PC | Anesthesiology | 1703 Meadows Lane, Vidalia, GA 30474 | 2006-05-04 |
| 1952393258 | Anthony D Mancuso | Anesthesiology | 1 Meadows Pkwy, Vidalia, GA 30474-8759 | 2005-08-22 |
| 1396116414 | Meadows Anesthesia LLC | Anesthesiology | 1 Meadows Pkwy, Vidalia, GA 30474-8759 | 2015-10-15 |
| 1104111731 | Sarah F Campbell | Anesthesiology | 1 Meadows Pkwy, Vidalia, GA 30474-8759 | 2011-06-11 |
| 1629139142 | George A Ferrara | Anesthesiology | 1703 Meadows Ln, Vidalia, GA 30474-8915 | 2006-12-12 |
| 1861454753 | Stacie L Wong | Anesthesiology | 1 Meadows Pkwy, Vidalia, GA 30474-8759 | 2006-04-05 |
| 1598758807 | Laila Mozdab | Anesthesiology | 1 Meadows Pkwy, Vidalia, GA 30474-8759 | 2005-08-23 |
| 1194718494 | Frank Gibase | Anesthesiology | 1 Meadows Pkwy, Vidalia, GA 30474-8759 | 2005-08-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053918441 | Nicole Marie Tetro | Anesthesiology | Candler Hospital, 5353 Reynolds St, Savannah, GA 31405 | 2020-10-08 |
| 1306463013 | Pain Spine Md LLC | Anesthesiology | 3993 Lawrenceville Hwy Nw Ste 115, Lilburn, GA 30047-2831 | 2020-06-29 |
| 1235754151 | Anesthesiologists for Dental Sedation LLC | Anesthesiology | 4151 Steve Reynolds Blvd, Norcross, GA 30093-3060 | 2020-06-16 |
| 1497370035 | Maria Gabriela Sanchez Gonzalez | Anesthesiology | 1120 15th St # Bi-2144, Augusta, GA 30912-0004 | 2020-06-09 |
| 1992325641 | Oconee River Anesthesia Associates | Anesthesiology | 1360 Caduceus Way Bldg 300, Watkinsville, GA 30677-7300 | 2020-04-23 |
| 1174085757 | Pain Physicians of America, LLC | Anesthesiology | 3333 Old Milton Parkway, Suite 400, Alpharetta, GA 30005-4437 | 2019-04-03 |
| 1215404892 | Seaworthy Anesthesia, LLC | Anesthesiology | 109 Worthing Rd, St Simons Island, GA 31522-1928 | 2018-10-31 |
| 1205318029 | At Your Service Anesthesia, LLC | Anesthesiology | 2056 W Park Place Blvd Ste F, Stone Mountain, GA 30087-3537 | 2018-08-29 |
| 1750877676 | Gastro Anesthesia Services | Anesthesiology | 4150 Dep Bill Cantrell Memorial Rd Ste 200, Cumming, GA 30040-3005 | 2018-07-03 |
| 1437644226 | Prathik Mudaliar Mudaliar | Anesthesiology | 11250 15th Street, Augusta, GA 30912-0001 | 2018-06-25 |
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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.