MRS. MARY E LOTT (NPI# 1629294665) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629294665 |
| Entity Type | Individual |
| Full Name | MRS. MARY E LOTT |
| Credential | M.D. |
| Practice Address |
711 Charles Gilman Jr Ave Ste B Kingsland GA 31548-5664 |
| Mailing Address |
218 Quarterman St Waycross GA 31501 |
| Practice Telephone | 9125109728 |
| Practice Fax Number | 9125109752 |
| Mailing Telephone | (912) 287-0301 |
| Mailing Fax Number | 9122871568 |
| Enumeration Date | 2007-04-18 |
| Last Update Date | 2018-03-17 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | 62137 | GA | Allopathic & Osteopathic Physicians |
| N | 2080H0002X |
Pediatrics Specialization: Hospice and Palliative Medicine |
001265 | GA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 369518390E | 05 | |
| GA | EMPLOYER ID | GRP2665 | 01 |
| GA | BCBS | 52319773 | 01 |
| GA | RESIDENCY LICENSE | 001265 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 218 Quarterman St, Waycross, GA 31501 | (912) 287-0301 | 9122871568 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891316972 | Mary Lott | Counselor | 6300 W Denton St, Boise, ID 83704-9326 | 2020-04-30 |
| 1952720500 | Mary Lott | Pharmacist | 105 Keith Lott Rd, Poplarville, MS 39470-7462 | 2014-04-10 |
| 1043278575 | Mary E Lott | Psychologist | 500 University Dr, Hershey, PA 17033-2360 | 2006-05-03 |
| Street Address |
711 CHARLES GILMAN JR AVE STE B |
| City | KINGSLAND |
| State | GA |
| Zip Code | 31548-5664 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700269958 | Courtney Marie Popwell | Nurse Practitioner | 711 Charles Gilman Jr Ave Ste B, Kingsland, GA 31548-5664 | 2015-07-07 |
| 1821476193 | Mckinney Medical Center Inc | Clinic/Center | 711 Charles Gilman Jr Ave Ste B, Kingsland, GA 31548-5664 | 2015-05-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356984611 | Shelby Nichole Gambill | Nurse Practitioner | 103 Lake Palms Dr, Kingsland, GA 31548 | 2019-10-18 |
| 1629536339 | The Behavior Placellc | Behavior Technician | 103 Johansen Way, Kingsland, GA 31548 | 2019-03-12 |
| 1588020234 | Keywanna Nichole Price | Nurse Practitioner | 571 Henrietta St, Kingsland, GA 31548 | 2016-01-11 |
| 1083086243 | Sorinity Support Services, LLC | Nurse's Aide | 801 Hwy 40 East Ste A-139, Kingsland, GA 31548 | 2015-10-28 |
| 1740661594 | Briana Gray | Family Medicine | 1375 E King Ave Ste B, Kingsland, GA 31548 | 2015-06-17 |
| 1649670530 | Kimberly Grande | Physical Therapist | 100 B Lindsey Lane, Kingsland, GA 31548 | 2014-08-27 |
| 1598044307 | Margaret Peek Powell | Counselor | 100 Mariners Dr. Suite D, Kingsland, GA 31548 | 2011-08-10 |
| 1376850545 | Heavenly Devine Blessing | Home Delivered Meals | 105 North Lee Street, Kingsland, GA 31548 | 2010-09-08 |
| 1053649657 | Melissa Anne White | Nurse Practitioner | 701 Charles Gilman Jr Ave Ste B, Kingsland, GA 31548 | 2009-11-20 |
| 1629203690 | Genevieve Matherne | Occupational Therapist | 100b Lindsey Lane, Kingsland, GA 31548 | 2009-05-20 |
| Find all providers in zip 31548 | ||||
| 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 |
|---|---|---|---|---|
| 1801920467 | Bryan Charles Weatherspoon | Pediatrics | 51 Lindsey Ln, Kingsland, GA 31548-6836 | 2007-03-15 |
| 1851399307 | Sujay G Patel | Pediatrics | 39 Andrews Way, Kingsland, GA 31548-6833 | 2005-07-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063025690 | Sas Medical LLC | Pediatrics | 8601 Dunwoody Pl Ste 565, Sandy Springs, GA 30350-2519 | 2020-08-24 |
| 1467063248 | Kindercare Pediatrics of Georgia | Pediatrics | 174 Royal Oak Dr, Guyton, GA 31312-5624 | 2020-08-13 |
| 1649880667 | Grayson Pediatrics Mobile | Pediatrics | 297 Cooper Rd Ste B, Loganville, GA 30052-2518 | 2020-08-04 |
| 1134745953 | Molly C Shields | Pediatrics | Dugas Building Bg 107 1120 15th Street, Augusta, GA 30912-0001 | 2020-06-17 |
| 1033734918 | Lauren Wooten Smith | Pediatrics | Chog Pediatric Residency Program 1120 15th Street, Augusta, GA 30912-0001 | 2020-06-16 |
| 1225667314 | Moyosore Mary Abere | Pediatrics | 104 Bluff Chase, Bonaire, GA 31005-3867 | 2020-04-02 |
| 1447886155 | Natalie Brown Shumate | Pediatrics | 1669 Pleasant Valley Rd Ne, Monroe, GA 30655-6211 | 2020-03-14 |
| 1356988455 | Maura Mchugh Barrett | Pediatrics | 1805 Parke Plaza Cir Ste 103, Stone Mountain, GA 30087-3646 | 2019-12-08 |
| 1629614060 | Kaley Adams | Pediatrics | 227 Torrington Blvd, Thomasville, GA 31757-3904 | 2019-11-20 |
| 1164066791 | Holly Savino | Pediatrics | 603 Old Norcross Rd Ste A, Lawrenceville, GA 30046-4315 | 2019-11-06 |
| 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.