TATTNALL HOSPITAL COMPANY, LLC (NPI# 1790112571) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790112571 |
| Entity Type | Organization |
| Organization Name | TATTNALL HOSPITAL COMPANY, LLC |
| Other Organization Name | OPTIM SURGICAL ASSOCIATES - VIDALIA |
| Practice Address |
1702-a Meadows Lane Vidalia GA 30474 |
| Mailing Address |
210 E Derenne Ave Savannah GA 31405-6736 |
| Practice Telephone | 9125379421 |
| Mailing Telephone | 9126296935 |
| Mailing Fax Number | 9126443369 |
| Enumeration Date | 2013-10-10 |
| Last Update Date | 2013-10-10 |
| Authorized Official Name | MICHAEL KLEINPETER (CEO) |
| Authorized Official Telephone | 9126445300 |
| Is Organization Subpart | Y |
| Parent Organization Name | TATTNALL HOSPITAL COMPANY, LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208600000X | Surgery | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Optim Surgical Associates - Vidalia | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912566811 | Tattnall Hospital Company, LLC | Clinic/Center | 10200 Ford Ave Ste 105, Richmond Hill, GA 31324-8824 | 2019-06-13 |
| 1285132415 | Tattnall Hospital Company, LLC | Family Medicine | 380a Cedar St, Metter, GA 30439 | 2018-01-23 |
| 1558878884 | Tattnall Hospital Company, LLC | Neurological Surgery | 242 Industrial Blvd, Dublin, GA 31021 | 2018-01-09 |
| 1093115123 | Tattnall Hospital Company, LLC | Neurological Surgery | 3345 Us Highway 84, Suite 100, Blackshear, GA 31516-2159 | 2014-08-26 |
| 1720322464 | Tattnall Hospital Company, LLC | Orthopaedic Surgery | 38 S. Tallahassee Street, Suite B, Hazlehurst, GA 31539 | 2012-11-19 |
| 1013261312 | Tattnall Hospital Company, LLC | Physical Medicine & Rehabilitation | 8. North Williams Street, Metter, GA 30439 | 2012-11-08 |
| 1245501063 | Tattnall Hospital Company, LLC | Physical Medicine & Rehabilitation | 5918 Ogeechee Rd, Savannah, GA 31419-9527 | 2012-01-25 |
| 1154614360 | Tattnall Hospital Company, LLC | Family Medicine | 1811 Edwina Drive, Vidalia, GA 30474 | 2011-05-20 |
| 1891009924 | Tattnall Hospital Company, LLC | Orthopaedic Surgery | 110 East Tollison Street, Baxley, GA 31513 | 2010-07-30 |
| 1356579296 | Tattnall Hospital Company, LLC | Physician Assistant | 230 Industrial Blvd, Dublin, GA 31021 | 2009-06-30 |
| Street Address |
1702-A MEADOWS LANE |
| City | VIDALIA |
| State | GA |
| Zip Code | 30474 |
| 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 |
| 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 |
| 1871714600 | John Holmes Talton | Dentist | 316a Maple Drive, Vidalia, GA 30474 | 2007-05-01 |
| Find all providers in zip 30474 | ||||
| Taxonomy Code | 208600000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery. |
| 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 Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275641995 | Walter J Revell Jr. | Surgery | 305 W 1st St, Vidalia, GA 30474-3302 | 2006-08-25 |
| 1376504647 | Michael Anthony Williams | Surgery | 1604 Meadows Ln, Vidalia, GA 30474-8914 | 2006-03-28 |
| 1144289349 | Robert Bicknell Clark Jr. | Surgery | 1811 Manning Dr, Vidalia, GA 30474-8921 | 2006-03-17 |
| 1891109880 | Henry Leon Ferland IIi | Surgery | 1811 Edwina Dr, Vidalia, GA 30474-8963 | 2014-06-17 |
| 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 |
| 1760692388 | Robert S Riddick Mdpc | Surgery | 106 Queen Street, Suite 4, Vidalia, GA 30474 | 2007-05-23 |
| 1639247414 | Mppg, Inc. | Surgery | 200 Maple Drive, Vidalia, GA 30474 | 2006-12-01 |
| 1780672287 | Gregory Norkus | Surgery | 1811 Edwina Dr, Vidalia, GA 30474-8963 | 2005-10-10 |
| 1437145208 | Kurt Patrick Hofmann | Surgery | 1811 Edwina Dr, Vidalia, GA 30474-8963 | 2005-09-27 |
| Find all providers in VIDALIA | ||||
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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.