DR. RAYMOND AVERY MOODY III (NPI# 1356559801) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356559801 |
| Entity Type | Individual |
| Full Name | DR. RAYMOND AVERY MOODY III |
| Credential | D.O. |
| Practice Address |
3567 Val-tech Rd. Valdosta State Prison Valdosta GA 31602 |
| Mailing Address |
504 Gornto Rd Valdosta GA 31602-1602 |
| Practice Telephone | 2293337963 |
| Mailing Telephone | 2292531267 |
| Enumeration Date | 2007-05-18 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 051990 | GA | Allopathic & Osteopathic Physicians |
| Street Address |
3567 VAL-TECH RD. VALDOSTA STATE PRISON |
| City | VALDOSTA |
| State | GA |
| Zip Code | 31602 |
| 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 | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760793178 | Frantz E Felix | Family Medicine | 3879 Island Creek Rd, Valdosta, GA 31601-0189 | 2010-06-30 |
| 1598084386 | Laura Guadiana | Family Medicine | 3374 Greystone Way, Valdosta, GA 31605-1096 | 2010-05-19 |
| 1912138116 | Parrott Medical Clinic PC | Family Medicine | 804 Northwood Park Dr, Valdosta, GA 31602-1392 | 2009-08-05 |
| 1184854226 | Quality Group Service Inc | Family Medicine | 3338 Country Club Rd Ste L, Ste. 200, Valdosta, GA 31605-7425 | 2009-07-23 |
| 1720224298 | Southern Skin & Wellness Center | Family Medicine | 3321 N Valdosta Rd Ste B, Valdosta, GA 31602-1685 | 2009-01-05 |
| 1033234315 | Jeri Lynn Sheffield | Family Medicine | 3548b Northcrossing Cir, Valdosta, GA 31602-1067 | 2007-03-19 |
| 1154401107 | Vera C Garcia | Family Medicine | 4370 Kings Way Ste E, Valdosta, GA 31602 | 2006-10-16 |
| 1629177324 | Jennetta M Christie | Family Medicine | 2317 Bemiss Rd, Valdosta, GA 31602-1934 | 2006-09-21 |
| 1831107234 | Marian Antoinette Patterson | Family Medicine | 3790 Old Us Highway 41 N Ste A, Bldg N, Valdosta, GA 31602-6865 | 2006-08-03 |
| 1609809300 | Richard W Rickman | Family Medicine | 201 Woodrow Wilson Dr, Valdosta, GA 31602 | 2006-07-08 |
| 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.