SOUTHWELL AMBULATORY INC (NPI# 1720693047) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720693047 |
| Entity Type | Organization |
| Organization Name | SOUTHWELL AMBULATORY INC |
| Other Organization Name | SOUTHWELL OB/GYN |
| Practice Address |
814 Northwood Park Dr Valdosta GA 31602-1398 |
| Mailing Address |
410 Connell Rd Valdosta GA 31602-1898 |
| Practice Telephone | 2292626810 |
| Practice Fax Number | 2293534901 |
| Mailing Telephone | 2293536889 |
| Mailing Fax Number | 2292471084 |
| Enumeration Date | 2020-09-14 |
| Last Update Date | 2020-10-08 |
| Authorized Official Name | LINDA A WILSON (VP REVENUE CYCLE) |
| Authorized Official Telephone | 2293533400 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207V00000X | Obstetrics & Gynecology | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Southwell OB/GYN | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 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 |
| 1720625296 | Southwell Ambulatory Inc | Clinic/Center | 410 Connell Road, Valdosta, GA 31602-1407 | 2019-12-04 |
| 1215574926 | Southwell Ambulatory Inc | Clinic/Center | 3207 Country Club Drive, Valdosta, GA 31605-1029 | 2019-12-02 |
| Street Address |
814 NORTHWOOD PARK DR |
| City | VALDOSTA |
| State | GA |
| Zip Code | 31602-1398 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679542781 | Douglas Moss | Emergency Medicine | 814 Northwood Park Dr, Valdosta, GA 31602-1398 | 2006-03-14 |
| 1609189943 | South Georgia Health Group LLC | Durable Medical Equipment & Medical Supplies | 814 Northwood Park Dr, Valdosta, GA 31602-1398 | 2010-07-15 |
| 1306091376 | South Georgia Health Group, LLC | Internal Medicine | 814 Northwood Park Dr, Valdosta, GA 31602-1398 | 2008-11-18 |
| 1245484427 | Grant Nh LLC | Internal Medicine | 814 Northwood Park Dr, Valdosta, GA 31602-1398 | 2008-11-14 |
| 1518150838 | Tgs, LLC | Obstetrics & Gynecology | 814 Northwood Park Dr, Valdosta, GA 31602-1398 | 2007-08-21 |
| 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 | 207V00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Obstetrics and Gynecology, 2007. http://www.abog.org/. American Osteopathic Board of Obstetrics and Gynecology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Obstetrics and Gynecology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Obstetrics and Gynecology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740591833 | Nellie Sarah Crawford | Obstetrics & Gynecology | 2601 Bemiss Rd Ste A, Valdosta, GA 31602-1430 | 2010-06-23 |
| 1801951454 | Southern Ob Gyn Associates P C | Obstetrics & Gynecology | 220 Northside Dr, Valdosta, GA 31602-1858 | 2006-12-26 |
| 1467468561 | Jerthitia S Taylor | Obstetrics & Gynecology | 2601 Bemiss Rd, Suite A, Valdosta, GA 31602-1445 | 2006-07-31 |
| 1932175726 | Danielle Mcfarland | Obstetrics & Gynecology | 604 E Park Ave, Valdosta, GA 31602-3060 | 2006-02-23 |
| 1437396439 | Owen K Youles II | Obstetrics & Gynecology | 3811 Old Us Highway 41 N, Valdosta, GA 31602-6807 | 2009-01-13 |
| 1740366442 | Pamela H Temples | Obstetrics & Gynecology | 220 Northside Drive, Valdosta, GA 31602 | 2006-10-27 |
| 1447336185 | Alexander M Culbreth IIi | Obstetrics & Gynecology | 220 Northside Drive, Valdosta, GA 31602 | 2006-10-27 |
| 1255417994 | Joe C Clifton | Obstetrics & Gynecology | 220 Northside Drive, Valdosta, GA 31602 | 2006-10-27 |
| 1437235199 | Sara N Yarbrough | Obstetrics & Gynecology | 220 Northside Drive, Valdosta, GA 31602 | 2006-10-27 |
| 1851477558 | Frank Q Smith | Obstetrics & Gynecology | 220 Northside Drive, Valdosta, GA 31602 | 2006-10-27 |
| Find all providers in VALDOSTA | ||||
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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.