SOUTHWEST GEORGIA PEDIATRICS (NPI# 1457649774) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457649774 |
| Entity Type | Organization |
| Organization Name | SOUTHWEST GEORGIA PEDIATRICS |
| Practice Address |
1110 N Monroe St Albany GA 31701-1949 |
| Practice Telephone | 2298888121 |
| Practice Fax Number | 2298886374 |
| Mailing Telephone | 2298888121 |
| Mailing Fax Number | 2298886374 |
| Enumeration Date | 2011-07-20 |
| Last Update Date | 2011-07-20 |
| Authorized Official Name | DR. BRUCE A SMITH (PRESIDENT) |
| Authorized Official Telephone | 2298888121 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | Other Service Providers |
| Street Address |
1110 N MONROE ST |
| City | ALBANY |
| State | GA |
| Zip Code | 31701-1949 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538157631 | Stacy N Evans | Pediatrics | 1110 N Monroe St, Albany, GA 31701-1949 | 2005-10-12 |
| 1508428079 | Sarah Carlton Davenport | Nurse Practitioner | 1110 N Monroe St, Albany, GA 31701-1949 | 2019-07-03 |
| 1821086711 | Bruce Alexander Smith | Pediatrics | 1110 N Monroe St, Albany, GA 31701-1949 | 2005-10-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124678347 | Carehere LLC | Family Medicine | Carehere Clinic- City of Albany, Ga, 2000 North Monroe Street, Albany, GA 31701 | 2019-09-19 |
| 1801450788 | Amy Brock | Nurse Practitioner | 417 4th Avenue, Albany, GA 31701 | 2019-04-26 |
| 1346740131 | Kawana Kesia Mullins | Contractor | 1103 S Davis St, Albany, GA 31701 | 2018-02-19 |
| 1689198558 | Marion Elizabeth Toscano | Counselor | 226 South Jefferson Street, Frederick, MD 31701 | 2017-08-01 |
| 1871014803 | Mann Dental Care LLC | Clinic/Center | 1403 South Slappey Blvd, Albany, GA 31701 | 2017-06-29 |
| 1457716805 | Amanda Banks Thomas | Advanced Practice Midwife | 803 13th Avenue, Albany, GA 31701 | 2015-12-29 |
| 1265805212 | David Lee Berry Jr. | Counselor | 230 South Jackson Street, Suite 228 & 229, Albany, GA 31701 | 2015-11-12 |
| 1750725099 | Charles Jacob Stoudenmire | Pathology | 507 W 3rd Ave Ste 7, Albany, GA 31701 | 2013-04-17 |
| 1700188232 | Wendy Summer Willis | Podiatrist | 531 Seventh Avenue, Albany, GA 31701 | 2010-12-05 |
| 1760615413 | Nicholas L Misulia | Anesthesiology | 417 Third Avenue, Albany, GA 31701 | 2009-08-28 |
| Find all providers in zip 31701 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114428141 | Johnae Patrice Galloway | Specialist | 600 New Scotland Ave, Albany, NY 12208-1928 | 2018-02-25 |
| 1205373917 | Nicarro Henderson | Specialist | 2005 E Dawson Rd, Albany, GA 31707 | 2017-01-20 |
| 1457703217 | Rebecca Burke | Specialist | 113 Krumkill Rd, Albany, NY 12208-1249 | 2016-07-05 |
| 1639535933 | Emily Soule | Specialist | 687 Myrtle Ave, Apt 1, Albany, NY 12208-3711 | 2016-01-04 |
| 1891163903 | Anca Rabinowitz | Specialist | 22a Old Hickory Dr, Apt.2a, Albany, NY 12204-1137 | 2015-09-04 |
| 1609242197 | Jaclyn Whitman | Specialist | 230 Washington Ave Extention, Albany, NY 12203 | 2015-08-19 |
| 1548651706 | Katrina Reittinger | Specialist | 50 Phillip St, Albany, NY 12207 | 2015-02-10 |
| 1700226792 | Jeffrey Sansobrino | Specialist | 1 Rapp Rd # 1, Albany, NY 12203-4491 | 2013-07-05 |
| 1306186739 | Kate Ireland Panza | Specialist | 29 Krug Ct, Albany, NY 12211-1914 | 2013-02-21 |
| 1992045470 | Maryjo Aidala | Specialist | 1658 Central Ave, Albany, NY 12205-4029 | 2013-02-21 |
| Find all providers in ALBANY | ||||
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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.