JOSE MEDINA MD PC (NPI# 1407047269) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407047269 |
| Entity Type | Organization |
| Organization Name | JOSE MEDINA MD PC |
| Practice Address |
3334 Greystone Way Valdosta GA 31605-1096 |
| Mailing Address |
Po Box 3550 Valdosta GA 31604-3550 |
| Practice Telephone | 2292471667 |
| Practice Fax Number | 2292473456 |
| Mailing Telephone | 2292471667 |
| Mailing Fax Number | 2292473456 |
| Enumeration Date | 2007-08-07 |
| Last Update Date | 2010-06-15 |
| Authorized Official Name | DR. JOSE MEDINA (OWNER) |
| Authorized Official Telephone | 2292471667 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM1300X |
Clinic/Center Specialization: Multi-Specialty |
041166 | GA | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 00686507C | 05 |
| Street Address |
3334 GREYSTONE WAY |
| City | VALDOSTA |
| State | GA |
| Zip Code | 31605-1096 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417944513 | Jose Medina | Internal Medicine | 3334 Greystone Way, Valdosta, GA 31605 | 2005-10-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508484718 | Mckenna Kristine Bachmann | Specialist/Technologist | Moody Air Force Base, Valdosta, GA 31605 | 2020-07-14 |
| 1376056366 | Michael Brent Robinson Sr. | Contractor | 3863 Camellia Dr., Valdosta, GA 31605 | 2017-11-13 |
| 1679013452 | Baptist Specialty Physicians Inc | Pediatrics | 3301 N Oak St Ext, Valdosta, GA 31605 | 2017-02-28 |
| 1649683541 | Dustin Ross Kilby | Dentist | 2704 Oak Center Dr, Valdosta, GA 31605 | 2014-06-09 |
| 1659643286 | Brittnaey Nicole Freeman | Behavioral Analyst | 3982 Karaline Cir, Valdosta, GA 31605 | 2012-01-27 |
| 1780970335 | Laura Christen Cribbs | Counselor | 3312-d N Oak Street Ext, Valdosta, GA 31605 | 2011-06-22 |
| 1992090633 | Mary Katelyn Harper | Pharmacist | 3200 North Oak Street, Valdosta, GA 31605 | 2011-06-10 |
| 1053532937 | Robert Mark Pearson | Dentist | 3227 N. Oak St. Ext., Valdosta, GA 31605 | 2007-05-01 |
| 1083838650 | Am Sleep Diagnostics and Research Center | Clinic/Center | 3334 Greyatone Way, Valdosta, GA 31605 | 2007-04-12 |
| 1831236181 | William Ashley Moorman | Dentist | Advanced Dental Care, 3211 Wildwood Plantation Drive, Valdosta, GA 31605 | 2007-01-30 |
| Find all providers in zip 31605 | ||||
| Taxonomy Code | 261QM1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Multi-Specialty |
| Definition to come... |
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|---|---|---|---|---|
| 1538465786 | Js Medical Diagnostics, LLC | Clinic/Center | 3790 Old Us Hwy 41 N, Suite B, Valdosta, GA 31602 | 2011-02-07 |
| 1225412596 | Hospital Authority of Valdosta and Lowndes County, Georgia | Clinic/Center | 4280 N Valdosta Rd, Valdosta, GA 31602-6814 | 2015-07-16 |
| 1538200035 | Valdosta Medical Clinic | Clinic/Center | 3207 Country Club Dr, Valdosta, GA 31605-1029 | 2007-02-09 |
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| Find all providers with the same taxonomy | ||||
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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.