MRS. KIMBERLY LOTT (NPI# 1306802236) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306802236 |
| Entity Type | Individual |
| Full Name | MRS. KIMBERLY LOTT |
| Other Name | KIMBERLY RICKETSON |
| Credential | PA-C |
| Practice Address |
100 Doctors Dr Ste G Douglas GA 31533-2211 |
| Mailing Address |
Po Box 1377 Douglas GA 31534-1377 |
| Practice Telephone | 9123846186 |
| Practice Fax Number | 9123846187 |
| Mailing Telephone | (912) 384-1477 |
| Mailing Fax Number | 9123841470 |
| Enumeration Date | 2006-04-20 |
| Last Update Date | 2018-03-17 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
004095 | GA | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 173328689A | 05 | |
| GA | 173328689B | 05 | |
| GA | MEDICAL LICENSE | 004095 | 01 |
| GA | 173328689C | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 200 Doctors Dr Ste S, Douglas, GA 315332203 | 9122920658 | 9122920670 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659985851 | Kimberly Lzaett Lott | Licensed Vocational Nurse | 4113 Dawson Ln, Houston, TX 77051-3335 | 2020-09-04 |
| 1780027094 | Kimberly Lott | Pharmacist | 999 Fellsmere Rd, Sebastian, FL 32958-4861 | 2013-04-17 |
| 1023156114 | Kimberly A Lott | Social Worker | 1997 Highway 51 S, Covington, TN 38019-3630 | 2007-02-02 |
| Street Address |
100 DOCTORS DR STE G |
| City | DOUGLAS |
| State | GA |
| Zip Code | 31533-2211 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508371709 | Debbie Purvis | Nurse Practitioner | 100 Doctors Dr Ste G, Douglas, GA 31533-2211 | 2017-12-10 |
| 1053635078 | Thaihang Nguyen | Family Medicine | 100 Doctors Dr Ste G, Douglas, GA 31533-2211 | 2010-03-19 |
| 1790799740 | Lydia Chaney Tanner | Family Medicine | 100 Doctors Dr Ste G, Douglas, GA 31533-2211 | 2006-07-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508470964 | Swain Drug Company LLC | Pharmacy | 855 Bowens Mill Rd Sw Suite E, Douglas, GA 31533 | 2020-09-03 |
| 1811528649 | Unison Behavioral Health | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 211 North Street, Douglas, GA 31533 | 2020-01-30 |
| 1952940793 | Teresa Smith | Pharmacist | 901 W Ward St, Douglas, GA 31533 | 2019-12-26 |
| 1447641048 | Jennifer Spivey | Nurse Practitioner | 326 Shirley Avenue, Douglas, GA 31533 | 2015-02-18 |
| 1972914497 | Jessica Lynne Courson | Nurse Practitioner | 903 West Ward Street, Suite B, Douglas, GA 31533 | 2014-05-19 |
| 1063840296 | South Central Primary Care Center | Clinic/Center | 303 Shirley Ave, Ste B, Douglas, GA 31533 | 2013-10-25 |
| 1336411008 | Unison Behavioral Health | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 118 Coweta Avenue South, Douglas, GA 31533 | 2012-01-27 |
| 1346482700 | V and V Clinic | Pediatrics | 1020 West Bryan Street, Douglas, GA 31533 | 2009-04-01 |
| 1063650406 | Jayla Snipes Bullock | Speech-Language Pathologist | 618 Bowens Mill Road Sw, Douglas, GA 31533 | 2009-01-22 |
| 1417112707 | Southern Community Services Inc | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 315 S. Gaskin Ave, Douglas, GA 31533 | 2008-07-25 |
| Find all providers in zip 31533 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629456694 | Annsley Mathews Coffee | Physician Assistant | 312 Westside Dr, Douglas, GA 31533-3530 | 2015-05-11 |
| 1982610150 | Tara Roberts Spivey | Physician Assistant | 1208 Ocilla Rd, Douglas, GA 31533-2220 | 2006-07-31 |
| 1669825725 | Allison Barnett | Physician Assistant | 700 E Center St, Douglas, WY 82633-2446 | 2016-07-13 |
| 1578919643 | Victoria Suttles White | Physician Assistant | 312 Westside Dr, Douglas, GA 31533-3530 | 2016-05-09 |
| 1801194972 | Katrina D. Black | Physician Assistant | 205 Shirley Ave, Douglas, GA 31533-2327 | 2011-03-14 |
| 1962674176 | Billy Edward Roberts | Physician Assistant | 1101 Ocilla Rd Ste A, Douglas, GA 31533-2207 | 2008-03-27 |
| 1821125493 | Oscar Aguirre Jr. | Physician Assistant | 111 S 5th St, Douglas, WY 82633-2434 | 2007-02-28 |
| 1508938531 | Margaret S. Minchew | Physician Assistant | 2010 Ocilla Rd, Douglas, GA 31533-2230 | 2006-11-14 |
| 1225128754 | Sheila Sterkel | Physician Assistant | 111 S 5th St, Douglas, WY 82633-2434 | 2006-10-13 |
| 1902992555 | Lew Howard Cooksey | Physician Assistant | 111 S 5th St, Douglas, WY 82633 | 2006-10-04 |
| Find all providers in DOUGLAS | ||||
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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.