MRS. KEREESE S GAYLE-FARIAS (NPI# 1376805267) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376805267 |
| Entity Type | Individual |
| Full Name | MRS. KEREESE S GAYLE-FARIAS |
| Other Name | KEREESE S GAYLE |
| Credential | M.D. |
| Practice Address |
406 M Northside Drive Valdosta GA 31602 |
| Practice Telephone | 2292410059 |
| Practice Fax Number | 2292412088 |
| Mailing Telephone | (229) 241-0059 |
| Mailing Fax Number | 2292412088 |
| Enumeration Date | 2012-06-15 |
| Last Update Date | 2017-05-19 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | 74177 | GA | Allopathic & Osteopathic Physicians |
| Street Address |
406 M NORTHSIDE DRIVE |
| City | VALDOSTA |
| State | GA |
| Zip Code | 31602 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538139712 | Charlene Carla Blache | Pediatrics | 406 M Northside Drive, Valdosta, GA 31602-1853 | 2006-01-23 |
| 1700159589 | Susan Elizabeth Mackey-burns | Nurse Practitioner | 406 M Northside Drive, Valdosta, GA 31602-1853 | 2012-02-09 |
| 1982858767 | Southern Pediatric Clinic, LLC | Pediatrics | 406 M Northside Drive, Valdosta, GA 31602 | 2008-11-06 |
| 1760431191 | Virginia Parramore Cochran | Nurse Practitioner | 406 M Northside Drive, Valdosta, GA 31602-1853 | 2006-05-10 |
| 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 | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508945114 | Sandra L Feldman | Pediatrics | 312 N Patterson St, Valdosta, GA 31601-5526 | 2006-11-03 |
| 1770690703 | Jennifer M Collier-madon | Pediatrics | 101 W Northside Dr Bldg G, Valdosta, GA 31602-1754 | 2006-08-24 |
| 1609882091 | Janice Holly Loeffler | Pediatrics | 3014 N Patterson St, Valdosta, GA 31602-1711 | 2006-07-31 |
| 1538139712 | Charlene Carla Blache | Pediatrics | 406 M Northside Drive, Valdosta, GA 31602-1853 | 2006-01-23 |
| 1487632246 | Robert J Criscuola | Pediatrics | 3331 N Valdosta Rd, Valdosta, GA 31602 | 2006-01-03 |
| 1962035360 | Southwell Ambulatory Inc | Pediatrics | 3014 N Patterson St, Valdosta, GA 31602-1711 | 2020-02-14 |
| 1063839983 | Irene Murema | Pediatrics | 105 W Cranford Ave, Valdosta, GA 31602-2930 | 2014-03-28 |
| 1639512601 | Courtney Michele James | Pediatrics | 2707 N Forrest St, Valdosta, GA 31602-2057 | 2013-04-09 |
| 1982858767 | Southern Pediatric Clinic, LLC | Pediatrics | 406 M Northside Drive, Valdosta, GA 31602 | 2008-11-06 |
| 1487853636 | Romulo Alvarado | Pediatrics | 3440 N Valdosta Rd, Valdosta, GA 31602-1079 | 2007-07-17 |
| 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.