SOUTH GEORGIA PRIMARY CARE, INC. (NPI# 1689935306) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689935306 |
| Entity Type | Organization |
| Organization Name | SOUTH GEORGIA PRIMARY CARE, INC. |
| Practice Address |
204 E 15th St Alma GA 31510-2908 |
| Practice Telephone | 9126328244 |
| Practice Fax Number | 9126328315 |
| Mailing Telephone | 9126328244 |
| Mailing Fax Number | 9126328315 |
| Enumeration Date | 2012-05-30 |
| Last Update Date | 2012-07-19 |
| Authorized Official Name | JONATHAN D. WADE (PHYSICIAN/OWNER) |
| Authorized Official Telephone | 9126328244 |
| Authorized Official Credential | D.O. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207QA0000X |
Family Medicine Specialization: Adolescent Medicine |
Allopathic & Osteopathic Physicians |
| Street Address |
204 E 15TH ST |
| City | ALMA |
| State | GA |
| Zip Code | 31510-2908 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760433304 | Khaldon A Al Saadi | Surgery | 204 E 15th St, Alma, GA 31510-2908 | 2006-05-16 |
| 1467085217 | Janna Mullis Moody | Nurse Practitioner | 204 E 15th St, Alma, GA 31510-2908 | 2020-02-20 |
| 1952836504 | Crh Physician Practices, LLC | Surgery | 204 E 15th St, Alma, GA 31510-2908 | 2017-04-20 |
| 1558808626 | Sheryl Turner Cox | Nurse Practitioner | 204 E 15th St, Alma, GA 31510-2908 | 2017-01-26 |
| 1518318054 | Neha Kakkar | Internal Medicine | 204 E 15th St, Alma, GA 31510 | 2016-06-27 |
| 1912358755 | Ian Furtado | Family Medicine | 204 E 15th St, Alma, GA 31510-2908 | 2016-06-22 |
| 1093180481 | Kymberly D Anderson | Nurse Practitioner | 204 E 15th St, Alma, GA 31510-2908 | 2015-12-10 |
| 1336560952 | South Georgia Physicians Group, LLC | Surgery | 204 E 15th St, Alma, GA 31510 | 2013-12-27 |
| 1366769457 | Gabor Kovacs Md, LLC | Specialist | 204 E 15th St, Alma, GA 31510-2908 | 2010-04-28 |
| 1275777971 | Rachel Burke Glass | Pediatrics | 204 E 15th St, Alma, GA 31510-2908 | 2009-04-24 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427693407 | Shepard Therapy Center | Occupational Therapist | 139 Ga Highway 32 Byp, Alma, GA 31510 | 2019-11-13 |
| 1760027320 | Sean Shepard | Physical Therapist | 139 Ga Hwy 32 Bypass, Alma, GA 31510 | 2019-11-07 |
| 1043875586 | Tricare Ambulance Service L.L.C. | Ambulance | 172 Pine Hollow Ln, Alma, GA 31510 | 2019-05-09 |
| 1053806299 | Eva Fedd | Counselor | 901 North Pierce St, Alma, GA 31510 | 2018-06-29 |
| 1730570268 | Wal-mart Stores East Lp | Durable Medical Equipment & Medical Supplies | 1041 S Us Highway 1, Alma, GA 31510 | 2015-02-05 |
| 1356475644 | Bacon County Family Medicine, LLC | Family Medicine | 205 South Wayne Street, Alma, GA 31510 | 2007-03-16 |
| 1720124043 | Unison Behavioral Health | Day Training, Developmentally Disabled Services | 1835 W 12th Street, Alma, GA 31510 | 2007-01-30 |
| 1891832952 | Unison Behavioral Health | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 123 Quart Douglas Road, Alma, GA 31510 | 2007-01-30 |
| 1992899082 | George Joel Williams Jr. | Dentist | 408 E 16th St, George J Williams Dds, Alma, GA 31510 | 2006-10-03 |
| 1093829343 | Charles E Bagley Mdpc | Family Medicine | 210 E 16th Street, Alma, GA 31510 | 2006-08-17 |
| Find all providers in zip 31510 | ||||
| Taxonomy Code | 207QA0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Specialization | Adolescent Medicine |
| A family medicine physician with multidisciplinary training in the unique physical, psychological and social characteristics of adolescents and their health care problems and needs. |
| 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 Family Medicine, 2007. http://www.theabfm.org/. American Osteopathic Board of Family Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619529393 | Christina Mae Allen | Family Medicine | 300 Dawson Commons Cir Ste 320, Dawsonville, GA 30534-6268 | 2019-07-12 |
| 1477882678 | Ramon Antonio Arias | Family Medicine | 4320 Flint Hill Rd, Austell, GA 30106-1718 | 2009-12-17 |
| 1235308750 | Mary Jean Cardin | Family Medicine | 157 Linkside Dr, Saint Simons Island, GA 31522-1154 | 2008-02-28 |
| 1366645699 | Vinod Kumar Sachdeva | Family Medicine | 1412 Plunkett Rd., Dooly Sp, Unadilla, GA 31091 | 2007-06-06 |
| 1255746186 | Arin Swerlick | Family Medicine | 35 Jesse Hill Jr Dr Se, Atlanta, GA 30303-3032 | 2014-06-30 |
| 1346419710 | Kids & Teens Primary Healthcare | Family Medicine | 2785 Lawrenceville Hwy, Suite 207, Decatur, GA 30033 | 2008-02-29 |
| 1063505550 | Donna L Mccann | Family Medicine | 210 W Main St, Ste 4, Colquitt, GA 39837 | 2006-10-02 |
| 1871544775 | Germaine Denise Cummings | Family Medicine | 4480 Atlanta Hwy, Loganville, GA 30052-7313 | 2006-05-15 |
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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.