ROBERT SCANLON (NPI# 1609874197) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609874197 |
| Entity Type | Individual |
| Full Name | ROBERT SCANLON |
| Credential | DO |
| Practice Address |
1811 Edwina Dr Vidalia GA 30474-8963 |
| Mailing Address |
Po Box 407 Vidalia GA 30475-0407 |
| Practice Telephone | 9125388105 |
| Practice Fax Number | 9125388109 |
| Mailing Telephone | 9125374986 |
| Enumeration Date | 2005-07-08 |
| Last Update Date | 2019-10-17 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207RC0200X |
Internal Medicine Specialization: Critical Care Medicine |
65886 | GA | Allopathic & Osteopathic Physicians |
| Y | 207RP1001X |
Internal Medicine Specialization: Pulmonary Disease |
65886 | GA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| HEALTHNET | 2K3975 | 01 | |
| CIGNA | 9392179 | 01 | |
| AETNA | 3263210 | 01 | |
| OXFORD | P2754298 | 01 | |
| GA | 003107027A | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013915792 | Robert Clayton Scanlon II | Urology | 1001 E Primrose St, Springfield, MO 65807-5155 | 2005-07-07 |
| 1790997567 | Robert Clayton Scanlon IIi | Emergency Medicine | 1000 Carondelet Dr, Attn: Emergency Department, Kansas City, MO 64114-4673 | 2007-05-04 |
| 1447314455 | Robert T Scanlon | Physical Therapist | 47 Maple St, Summit, NJ 07901-2571 | 2006-12-21 |
| 1740296722 | Robert F. Scanlon Jr. | Obstetrics & Gynecology | 270 Park Ave, Huntington, NY 11743-2787 | 2006-07-31 |
| Street Address |
1811 EDWINA DR |
| City | VIDALIA |
| State | GA |
| Zip Code | 30474-8963 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225531197 | Southeast Regional Primary Care Corporation | Internal Medicine | 1811 Edwina Dr, Vidalia, GA 30474-8963 | 2018-03-16 |
| 1568997914 | Debra Durden | Nurse Practitioner | 1811 Edwina Dr, Vidalia, GA 30474-8963 | 2017-04-24 |
| 1891109880 | Henry Leon Ferland IIi | Surgery | 1811 Edwina Dr, Vidalia, GA 30474-8963 | 2014-06-17 |
| 1346587755 | Joseph G Foust Md LLC | Family Medicine | 1811 Edwina Dr, Vidalia, GA 30474-8963 | 2013-01-07 |
| 1760702328 | Joy M Dunn | Surgery | 1811 Edwina Dr, Vidalia, GA 30474-8963 | 2010-06-07 |
| 1831325356 | Kendrix Jermaine Evans | Surgery | 1811 Edwina Dr, Vidalia, GA 30474-8963 | 2009-06-10 |
| 1194985093 | Vidalia Pulmonology Center, LLC | Internal Medicine | 1811 Edwina Dr, Vidalia, GA 30474-8963 | 2008-06-13 |
| 1124216312 | Vidalia Surgical Associates, LLC | Specialist | 1811 Edwina Dr, Vidalia, GA 30474-8963 | 2007-10-12 |
| 1649470410 | Southeast Ga Primary Prevent | Family Medicine | 1811 Edwina Dr, Vidalia, GA 30474-8963 | 2007-07-20 |
| 1396944633 | Southeastern Cardiology | Internal Medicine | 1811 Edwina Dr, Vidalia, GA 30474-8963 | 2007-07-17 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730655374 | Abby Virginia Adams | Speech-Language Pathologist | 101 Harris Insustrial Blvd, Vidalia, GA 30474 | 2018-10-22 |
| 1467930156 | Laurel Shiver Sapp | Nurse Practitioner | 1608 Meadows Ln, Vidalia, GA 30474 | 2018-08-03 |
| 1235658931 | Mary Frances Andrews | Nurse Practitioner | 1608 Meadows Lane Suite 1, Vidalia, GA 30474 | 2017-09-13 |
| 1154714574 | Georgia Eye Institute of The Southeast, LLC | Optometrist | 104 Andrews Street, Suite 112, Vidalia, GA 30474 | 2015-03-10 |
| 1790112571 | Tattnall Hospital Company, LLC | Surgery | 1702-a Meadows Lane, Vidalia, GA 30474 | 2013-10-10 |
| 1801235312 | Paul Anderson Youth Home, Inc. | Substance Abuse Rehabilitation Facility | 1603 Mcintosh Street, Vidalia, GA 30474 | 2013-06-18 |
| 1043591076 | Kimberly Thigpen Evans | Nurse Practitioner | 621 East First Street, Unit B, Vidalia, GA 30474 | 2011-09-03 |
| 1154614360 | Tattnall Hospital Company, LLC | Family Medicine | 1811 Edwina Drive, Vidalia, GA 30474 | 2011-05-20 |
| 1255586053 | Vidalia Medical Partners Inc. | Home Health | 801 Mcnatt Street, Vidalia, GA 30474 | 2008-11-20 |
| 1154596419 | Jill Nicole Lawrence | Speech-Language Pathologist | 1400 Ne Main St, Bethany Alf, Vidalia, GA 30474 | 2008-04-28 |
| Find all providers in zip 30474 | ||||
| Taxonomy Code | 207RP1001X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Pulmonary Disease |
| An internist who treats diseases of the lungs and airways. The pulmonologist diagnoses and treats cancer, pneumonia, pleurisy, asthma, occupational and environmental diseases, bronchitis, sleep disorders, emphysema and other complex disorders of the lungs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437422821 | Costrini & Meadows, PC | Internal Medicine | 506 Jackson St, Vidalia, GA 30474-4730 | 2012-02-15 |
| 1649338997 | John E Schoell | Internal Medicine | 1707 Meadows Lane, Suite E, Vidalia, GA 30474 | 2006-12-05 |
| 1225531197 | Southeast Regional Primary Care Corporation | Internal Medicine | 1811 Edwina Dr, Vidalia, GA 30474-8963 | 2018-03-16 |
| 1134492531 | Costrini & Meadows, PC | Internal Medicine | 1 Meadows Pkwy, Vidalia, GA 30474-8759 | 2012-02-15 |
| 1750651865 | Southeast Lung & Critical Care Specialists, PC | Internal Medicine | 1006 Mount Vernon Rd, Vidalia, GA 30474-3029 | 2012-01-05 |
| 1144590233 | Costrini & Meadows, PC | Internal Medicine | 1006 Mount Vernon Rd, Vidalia, GA 30474-3029 | 2012-01-05 |
| 1760664270 | South Georgia Pulmonary, Critical Care and Sleep Medicine | Internal Medicine | 1707 Meadows Ln, Suite E, Vidalia, GA 30474-7200 | 2007-11-27 |
| 1457349110 | Barry Forrest Tillman | Internal Medicine | 107 Front St, Vidalia, LA 71373-2836 | 2005-10-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194337592 | Stefan Vincent Goldberg | Internal Medicine | 3239 Bolero Dr, Atlanta, GA 30341-5705 | 2020-08-18 |
| 1366064164 | Southeast Lung & Critical Care Specialists | Internal Medicine | 1745 City Circle Rd, Baxley, GA 31513-7059 | 2020-05-14 |
| 1205474954 | Tift Regional Health System, Inc | Internal Medicine | 1499 Kennedy Road, Suite A, Tifton, GA 31794-4177 | 2019-12-12 |
| 1659845790 | Frank J Demarco Jr Md LLC | Internal Medicine | 4465 Nelson Brogdon Blvd, Buford, GA 30518-3487 | 2019-01-11 |
| 1063915338 | Trident Pulmonary and Critical Care PC | Internal Medicine | 483 Upper Riverdale Rd Sw Ste E, Riverdale, GA 30274-2579 | 2018-03-13 |
| 1194235853 | Covenant Medical Group LLC | Internal Medicine | 3605 Sandy Plains Rd Ste 240-235, Marietta, GA 30066-3068 | 2017-10-09 |
| 1235659814 | Southeast Lung & Criticial Care Specialists, PC | Internal Medicine | 5356 Reynolds St Ste 303, Savannah, GA 31405-6018 | 2017-06-23 |
| 1619355427 | Southeast Lung & Critical Care Specialists, PC. | Internal Medicine | 400 Cedar St Ste 106, Candler County Hospital, Metter, GA 30439-3338 | 2015-05-13 |
| 1770989154 | Southeast Lung & Critical Care Specialists, PC | Internal Medicine | 800 East 68th Street, Landmark Hospital, Savannah, GA 31405 | 2014-11-12 |
| 1407267511 | Akshay Bhatnagar | Internal Medicine | 2301 Newnan Crossing Blvd E Ste 200, Newnan, GA 30265-2576 | 2014-05-12 |
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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.