EMERGENCY PHYSICIANS OF COFFEE COUNTY, LLC (NPI# 1336431030) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336431030 |
| Entity Type | Organization |
| Organization Name | EMERGENCY PHYSICIANS OF COFFEE COUNTY, LLC |
| Practice Address |
1101 Ocilla Rd Douglas GA 31533-2207 |
| Practice Telephone | 9123841900 |
| Practice Fax Number | 9123835667 |
| Mailing Telephone | 9123841900 |
| Mailing Fax Number | 9123835667 |
| Enumeration Date | 2011-05-12 |
| Last Update Date | 2011-05-12 |
| Authorized Official Name | LAVONDA CRAVEY (MANAGER) |
| Authorized Official Telephone | 9123841900 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207PE0004X |
Emergency Medicine Specialization: Emergency Medical Services |
Allopathic & Osteopathic Physicians |
| Street Address |
1101 OCILLA RD |
| City | DOUGLAS |
| State | GA |
| Zip Code | 31533-2207 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245238211 | Joel W Ferree | Internal Medicine | 1101 Ocilla Rd, Douglas, GA 31533-2207 | 2005-07-13 |
| 1982239141 | Candace Rose Musgrove | Nurse Practitioner | 1101 Ocilla Rd, Douglas, GA 31533-2262 | 2020-03-09 |
| 1750920336 | Alexis Courson | Nurse Practitioner | 1101 Ocilla Rd, Douglas, GA 31533-2207 | 2019-12-31 |
| 1649839994 | Bobby Joe Guess Jr. | Nurse Practitioner | 1101 Ocilla Rd, Douglas, GA 31533-2262 | 2019-06-11 |
| 1801390836 | Jodi Rogers | Nurse Practitioner | 1101 Ocilla Rd, Douglas, GA 31533-2207 | 2018-03-23 |
| 1518460781 | Amy Michelle Whitley | Nurse Practitioner | 1101 Ocilla Rd, Douglas, GA 31533-2207 | 2018-03-14 |
| 1487160362 | Richard Steven Keene | Nurse Practitioner | 1101 Ocilla Rd, Douglas, GA 31533-2207 | 2017-12-14 |
| 1316451735 | Beverly Denise Graham | Nurse Practitioner | 1101 Ocilla Rd, Douglas, GA 31533-2207 | 2017-11-21 |
| 1871010264 | Laura Melissa Steverson | Nurse Practitioner | 1101 Ocilla Rd, Douglas, GA 31533-2207 | 2017-08-25 |
| 1366974263 | Coffee Regional Medical Center, Inc | Medicare Defined Swing Bed Unit | 1101 Ocilla Rd, Douglas, GA 31533-2207 | 2017-03-30 |
| Find all providers in the same location | ||||
| 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 | 207PE0004X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| Specialization | Emergency Medical Services |
| An emergency medicine physician who specializes in non-hospital based emergency medical services (e.g., disaster site, accident scene, transport vehicle, etc.) to provide pre-hospital assessment, treatment, and transport patients. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A Certification of Added Qualifications (CAQ) is issued by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528675956 | Nextgen Ems LLC | Emergency Medicine | 121 Tyre Dr, Mcdonough, GA 30253-8542 | 2020-09-29 |
| 1710506233 | Rita Udom | Emergency Medicine | 2795 Davis Rd, Marietta, GA 30062-6670 | 2020-04-14 |
| 1629463500 | Quoc Vinh Ngo | Emergency Medicine | Wellstar West Georgia Medical Center, 1504 Vernon Road, Lagrange, GA 30240 | 2015-03-30 |
| 1831539253 | Andrew Wesley White | Emergency Medicine | 1120 15th St # Af1006, Augusta, GA 30912-4500 | 2013-06-29 |
| 1013141118 | Darren Deandre Naugles | Emergency Medicine | 8920 Firestone Cir, Duluth, GA 30097-6627 | 2009-05-05 |
| 1437393667 | Donald R. Dalbey | Emergency Medicine | 3725 Sweetwater Drive, Cumming, GA 30041 | 2009-05-01 |
| 1346411667 | Harvey E Schuck | Emergency Medicine | 427 Brentwood Dr Ne, Atlanta, GA 30305-3204 | 2008-03-14 |
| 1639364011 | Srihari Rao Malempati | Emergency Medicine | 535 Trimble Lake Ct Ne, Atlanta, GA 30342-2481 | 2007-09-10 |
| 1306060264 | Gary L Godlewski | Emergency Medicine | 4755 Wesleyan Woods Dr, Macon, GA 31210-4410 | 2007-04-12 |
| 1710030002 | Robert Lee Carlson Jr. | Emergency Medicine | 3900 Legacy Park Blvd Nw, Suite C-100, Kennesaw, GA 30144-7412 | 2007-01-19 |
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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.