SOUTHWELL AMBULATORY INC (NPI# 1306466206) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306466206 |
| Entity Type | Organization |
| Organization Name | SOUTHWELL AMBULATORY INC |
| Practice Address |
901 18th St E Tifton GA 31794-3648 |
| Mailing Address |
907 18th St E Ste 400 Tifton GA 31794-3684 |
| Practice Telephone | 2293827120 |
| Mailing Telephone | 2293533422 |
| Mailing Fax Number | 2293536060 |
| Enumeration Date | 2020-04-21 |
| Last Update Date | 2020-09-01 |
| Authorized Official Name | LINDA A WILSON (VP REVENUE CYCLE) |
| Authorized Official Telephone | 2293536889 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM1300X |
Clinic/Center Specialization: Multi-Specialty |
Ambulatory Health Care Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720693047 | Southwell Ambulatory Inc | Obstetrics & Gynecology | 814 Northwood Park Dr, Valdosta, GA 31602-1398 | 2020-09-14 |
| 1962035360 | Southwell Ambulatory Inc | Pediatrics | 3014 N Patterson St, Valdosta, GA 31602-1711 | 2020-02-14 |
| 1598304974 | Southwell Ambulatory Inc | Internal Medicine | 2301 N Ashley St, Valdosta, GA 31602-2620 | 2020-01-02 |
| 1164069472 | Southwell Ambulatory Inc | Internal Medicine | 410 Connell Road, Valdosta, GA 31602-1407 | 2019-12-05 |
| 1720625296 | Southwell Ambulatory Inc | Clinic/Center | 410 Connell Road, Valdosta, GA 31602-1407 | 2019-12-04 |
| 1215574926 | Southwell Ambulatory Inc | Clinic/Center | 3207 Country Club Drive, Valdosta, GA 31605-1029 | 2019-12-02 |
| Street Address |
901 18TH ST E |
| City | TIFTON |
| State | GA |
| Zip Code | 31794-3648 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003819467 | William A Guest | Internal Medicine | 901 18th St E, Tifton, GA 31794-3648 | 2005-05-31 |
| 1881203305 | Tift Regional Health System Inc | Family Medicine | 901 18th St E, Tifton, GA 31794-3648 | 2020-07-30 |
| 1407481146 | Justin Hugh Roberts | Physician Assistant | 901 18th St E, Tifton, GA 31794-3648 | 2020-03-03 |
| 1558992479 | Justin Giddens | Nurse Anesthetist, Certified Registered | 901 18th St E, Tifton, GA 31794-3648 | 2020-01-29 |
| 1629617147 | Taylor Burrage | Dietitian, Registered | 901 18th St E, Tifton, GA 31794-3648 | 2020-01-01 |
| 1871155002 | Christina Lynn Davis | Nurse Practitioner | 901 18th St E, Tifton, GA 31794-3648 | 2019-07-09 |
| 1306323415 | Lorenzo Gomez | Dietitian, Registered | 901 18th St E, Tifton, GA 31794-3648 | 2018-07-21 |
| 1720564677 | Erin Elizabeth Clemmons | Dietitian, Registered | 901 18th St E, Tifton, GA 31794-3648 | 2018-07-13 |
| 1851891063 | Sarah Loepker | Nurse Practitioner | 901 18th St E, Tifton, GA 31794-3648 | 2018-02-14 |
| 1720595457 | John William Roberts II | Registered Nurse | 901 18th St E, Tifton, GA 31794-3648 | 2018-01-03 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982234043 | Deloris Lunsford | Licensed Practical Nurse | 903 Washington St., Tifton, GA 31794 | 2020-01-17 |
| 1194383075 | William Jordan Kinnett | Registered Nurse | 1205 Tift Ave N, Tifton, GA 31794 | 2019-06-05 |
| 1598321200 | Courtlyn Christanna Fussell | Pharmacist | 2201 Hwy 41 N, Tifton, GA 31794 | 2019-05-17 |
| 1376027722 | Martha Gibbs | Nurse Practitioner | Affinity Clinic/west Campus, 2225 Us Hwy 41 North, Tifton, GA 31794 | 2018-09-21 |
| 1427541044 | Rebekah F Cottle | Speech-Language Pathologist | 2227 Highway 41 North, Tifton, GA 31794 | 2018-06-08 |
| 1790280857 | Tift Regional Health System Inc | Ophthalmology | 1803 Old Ocilla Road, Tifton, GA 31794 | 2018-03-29 |
| 1568975431 | Skyler Clark | Pharmacist | 2201 North 12th Street, Tifton, GA 31794 | 2017-11-14 |
| 1538606306 | Imagine Peace Counseling LLC | Counselor | 223 E 2nd Street, Suite B, Tifton, GA 31794 | 2017-01-31 |
| 1073056347 | Jessica Tumbling | Contractor | 219 Savannah Way, Tifton, GA 31794 | 2016-11-18 |
| 1992159503 | Joseph Thomas Seagraves Jr. | Nurse Practitioner | 901 East 18th Street, Tifton, GA 31794 | 2016-04-20 |
| Find all providers in zip 31794 | ||||
| Taxonomy Code | 261QM1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Multi-Specialty |
| Definition to come... |
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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.