PLASTIC SURGERY OPERATIVE SUITE, LLC (NPI# 1316121429) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316121429 |
| Entity Type | Organization |
| Organization Name | PLASTIC SURGERY OPERATIVE SUITE, LLC |
| Practice Address |
230 Northside Dr Valdosta GA 31602-1858 |
| Practice Telephone | 2292423002 |
| Enumeration Date | 2007-12-26 |
| Last Update Date | 2015-05-05 |
| Authorized Official Name | MANDY PARKS (PRACTICE ADMINISTRATOR) |
| Authorized Official Telephone | 2292423002 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QA1903X |
Clinic/Center Specialization: Ambulatory Surgical |
Ambulatory Health Care Facilities |
| Street Address |
230 NORTHSIDE DR |
| City | VALDOSTA |
| State | GA |
| Zip Code | 31602-1858 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811005655 | Sonya J. Merriman | Plastic Surgery | 230 Northside Dr, Valdosta, GA 31602-1858 | 2006-08-29 |
| 1407291024 | Mark Arthur Pleasants | Nurse Anesthetist, Certified Registered | 230 Northside Dr, Valdosta, GA 31602-1858 | 2013-05-09 |
| 1356521595 | Plastic Surgery Associates of Valdosta | Clinic/Center | 230 Northside Dr, Valdosta, GA 31602-1858 | 2007-11-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477198117 | Amber Michele Baugh | Behavior Technician | 2236 Bemiss Road, Valdosta, GA 31602 | 2019-11-15 |
| 1528611365 | Nishaben T. Patel | Nurse Practitioner | 3120 North Oak Street Extension, Suite B, Valdosta, GA 31602 | 2019-07-22 |
| 1427615871 | Blair Elizabeth Tomlinson | Nurse Practitioner | 2124 Lakeshore Drive, Valdosta, GA 31602 | 2019-05-21 |
| 1346704152 | Mildred Itaska Borowski | Counselor | 3790 North Highway 41, Suite A, Valdosta, GA 31602 | 2019-01-25 |
| 1962991703 | Southern Healthcare Alliance, LLC | Physical Medicine & Rehabilitation | 101-f W. Northside Drive, Valdosta, GA 31602 | 2018-05-08 |
| 1336636646 | Kaitlyn Thrift | Behavioral Analyst | 2225 Bemiss Road Suite D, Valdosta, GA 31602 | 2018-04-23 |
| 1407379845 | Lindsey Marie Richardson | Dentist | 103 W. Cranford Ave, Valdosta, GA 31602 | 2017-07-18 |
| 1962922427 | Taylor Nicole Fiveash | Nurse Practitioner | 101 W Northisde Dr, Bldg G, Valdosta, GA 31602 | 2017-06-26 |
| 1720520646 | Southern Sleepers Anesthesia LLC | Nurse Anesthetist, Certified Registered | 4120-b N. Valdosta Road, Valdosta, GA 31602 | 2016-11-09 |
| 1134670557 | Cataract and Laser Surgery Center of South Georgia, P.C. | Clinic/Center | 4120-b N. Valdosta Rd., Valdosta, GA 31602 | 2016-10-20 |
| Find all providers in zip 31602 | ||||
| Taxonomy Code | 261QA1903X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Ambulatory Surgical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134670557 | Cataract and Laser Surgery Center of South Georgia, P.C. | Clinic/Center | 4120-b N. Valdosta Rd., Valdosta, GA 31602 | 2016-10-20 |
| 1457770547 | Physicians Institute for Pain Management Asc, LLC | Clinic/Center | 3312 N Oak Street Ext Ste F, Valdosta, GA 31605-1065 | 2014-04-16 |
| 1689736118 | Voa Ambulatory Surgery Center | Clinic/Center | 3527 B North Valdosta Road, Valdosta, GA 31602 | 2006-12-14 |
| 1538166053 | Southern Ob Gyn Ambulatory Surgery Center, Inc | Clinic/Center | 341 Connell Rd, Valdosta, GA 31602-1471 | 2005-06-30 |
| 1104272780 | Ent of South Georgia Surgery Center LLC | Clinic/Center | 2805 N Oak St, Valdosta, GA 31602-5922 | 2016-05-12 |
| 1528404803 | Urological Clinic of Valdosta Ambulatory Surgical Center, LLC | Clinic/Center | 3294 N Oak Street Ext, Valdosta, GA 31605-6473 | 2013-05-14 |
| 1922280197 | North Oak Ambulatory Surgery Center, LLC | Clinic/Center | 2718 N Oak St, Valdosta, GA 31602-1781 | 2007-11-29 |
| 1912196494 | Valdosta Foot & Ankle Surgery Center, P.C. | Clinic/Center | 2800 N Oak St, Valdosta, GA 31602-1716 | 2007-10-19 |
| 1487782637 | Eyeassociates Surgery Center, Inc | Clinic/Center | 3024 N Patterson St, Valdosta, GA 31602-1711 | 2007-03-01 |
| 1073556338 | Valdosta Podiatry Associates, PC | Clinic/Center | 2718 N Oak St, Valdosta, GA 31602-1781 | 2006-06-14 |
| Find all providers in VALDOSTA | ||||
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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.