SOUTHWELL AMBULATORY INC (NPI# 1720625296) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720625296 |
| Entity Type | Organization |
| Organization Name | SOUTHWELL AMBULATORY INC |
| Practice Address |
410 Connell Road Valdosta GA 31602-1407 |
| Mailing Address |
907 E 18th Street Suite 400 Tifton GA 31794-3684 |
| Practice Telephone | 2292441570 |
| Practice Fax Number | 2292994291 |
| Mailing Telephone | 2293533422 |
| Mailing Fax Number | 2293536060 |
| Enumeration Date | 2019-12-04 |
| Last Update Date | 2019-12-04 |
| Authorized Official Name | LINDA WILSON (VP REVENUE CYCLE) |
| Authorized Official Telephone | 2293533403 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QE0800X |
Clinic/Center Specialization: Endoscopy |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Southwell Valdosta Endoscopy Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720693047 | Southwell Ambulatory Inc | Obstetrics & Gynecology | 814 Northwood Park Dr, Valdosta, GA 31602-1398 | 2020-09-14 |
| 1306466206 | Southwell Ambulatory Inc | Clinic/Center | 901 18th St E, Tifton, GA 31794-3648 | 2020-04-21 |
| 1962035360 | Southwell Ambulatory Inc | Pediatrics | 3014 N Patterson St, Valdosta, GA 31602-1711 | 2020-02-14 |
| 1598304974 | Southwell Ambulatory Inc | Internal Medicine | 2301 N Ashley St, Valdosta, GA 31602-2620 | 2020-01-02 |
| 1164069472 | Southwell Ambulatory Inc | Internal Medicine | 410 Connell Road, Valdosta, GA 31602-1407 | 2019-12-05 |
| 1215574926 | Southwell Ambulatory Inc | Clinic/Center | 3207 Country Club Drive, Valdosta, GA 31605-1029 | 2019-12-02 |
| Street Address |
410 CONNELL ROAD |
| City | VALDOSTA |
| State | GA |
| Zip Code | 31602-1407 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215990098 | George Sidney Staton | Internal Medicine | 410 Connell Road, Valdosta, GA 31602 | 2006-04-11 |
| 1164069472 | Southwell Ambulatory Inc | Internal Medicine | 410 Connell Road, Valdosta, GA 31602-1407 | 2019-12-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477198117 | Amber Michele Baugh | Behavior Technician | 2236 Bemiss Road, Valdosta, GA 31602 | 2019-11-15 |
| 1528611365 | Nishaben T. Patel | Nurse Practitioner | 3120 North Oak Street Extension, Suite B, Valdosta, GA 31602 | 2019-07-22 |
| 1427615871 | Blair Elizabeth Tomlinson | Nurse Practitioner | 2124 Lakeshore Drive, Valdosta, GA 31602 | 2019-05-21 |
| 1346704152 | Mildred Itaska Borowski | Counselor | 3790 North Highway 41, Suite A, Valdosta, GA 31602 | 2019-01-25 |
| 1962991703 | Southern Healthcare Alliance, LLC | Physical Medicine & Rehabilitation | 101-f W. Northside Drive, Valdosta, GA 31602 | 2018-05-08 |
| 1336636646 | Kaitlyn Thrift | Behavioral Analyst | 2225 Bemiss Road Suite D, Valdosta, GA 31602 | 2018-04-23 |
| 1407379845 | Lindsey Marie Richardson | Dentist | 103 W. Cranford Ave, Valdosta, GA 31602 | 2017-07-18 |
| 1962922427 | Taylor Nicole Fiveash | Nurse Practitioner | 101 W Northisde Dr, Bldg G, Valdosta, GA 31602 | 2017-06-26 |
| 1720520646 | Southern Sleepers Anesthesia LLC | Nurse Anesthetist, Certified Registered | 4120-b N. Valdosta Road, Valdosta, GA 31602 | 2016-11-09 |
| 1134670557 | Cataract and Laser Surgery Center of South Georgia, P.C. | Clinic/Center | 4120-b N. Valdosta Rd., Valdosta, GA 31602 | 2016-10-20 |
| Find all providers in zip 31602 | ||||
| Taxonomy Code | 261QE0800X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Endoscopy |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215574926 | Southwell Ambulatory Inc | Clinic/Center | 3207 Country Club Drive, Valdosta, GA 31605-1029 | 2019-12-02 |
| 1700943958 | Lowndes County Ambulatory Surgical Center | Clinic/Center | 3207 Country Club Dr, Valdosta, GA 31605-1029 | 2007-01-03 |
| 1831134121 | Valdosta Endoscopy Center, LLC | Clinic/Center | 410 Connell Rd, Valdosta, GA 31602-1407 | 2006-06-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376052928 | Newnan Endoscopy Center LLC | Clinic/Center | 1200 Lower Fayetteville Rd, Newnan, GA 30263 | 2017-09-27 |
| 1275871147 | Panola Endoscopy Center LLC | Clinic/Center | 5403 Hillandale Park Court, Suite A, Lithonia, GA 30058 | 2013-01-28 |
| 1760778765 | Gastrointestinal Diagnostic Endoscopy Woodstock, LLC | Clinic/Center | 118 Mill St, Suite 100, Woodstock, GA 30188-4879 | 2011-06-28 |
| 1558662858 | Athens Endoscopy, LLC | Clinic/Center | 21 Jefferson Pl Ste 2, Athens, GA 30601-1761 | 2010-11-03 |
| 1518127398 | Snooze, LLC | Clinic/Center | 307 Market Ct, Canton, GA 30114-4562 | 2008-06-14 |
| 1184714214 | Gainesville Endoscopy Center, LLC | Clinic/Center | 2324 Limestone Overlook Ste 200, Gainesville, GA 30501-7443 | 2006-10-12 |
| 1023102266 | Cobb Endoscopy Center LLC | Clinic/Center | 3969 South Cobb Dr, Suite 207, Smyrna, GA 30080 | 2006-10-03 |
| 1659384329 | Endoscopy Center LLC | Clinic/Center | 1139 Lexington Ave Ste B, Savannah, GA 31404 | 2006-08-14 |
| 1194761908 | Gwinnett Endoscopy Center, PC | Clinic/Center | 301 Philip Blvd, Suite B, Lawrenceville, GA 30046-8745 | 2006-06-21 |
| 1063458909 | Woodstock Endoscopy Center | Clinic/Center | 900 Towne Lake Pkwy Ste 310, Woodstock, GA 30189-1604 | 2006-06-21 |
| 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.