RICHARD WA RICKMAN LLC (NPI# 1790147908) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790147908 |
| Entity Type | Organization |
| Organization Name | RICHARD WA RICKMAN LLC |
| Practice Address |
2804 N Oak St Suite A Valdosta GA 31602-5914 |
| Practice Telephone | 2294697730 |
| Practice Fax Number | 2294697729 |
| Mailing Telephone | 2294697730 |
| Mailing Fax Number | 2294697729 |
| Enumeration Date | 2016-03-26 |
| Last Update Date | 2016-05-23 |
| Authorized Official Name | DR. RICHARD RICKMAN (MEDICAL DOCTOR) |
| Authorized Official Telephone | 2294697729 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 305R00000X | Preferred Provider Organization | 049332 | GA | Managed Care Organizations |
| Street Address |
2804 N OAK ST SUITE A |
| City | VALDOSTA |
| State | GA |
| Zip Code | 31602-5914 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023022290 | Samuel E Worthington Iv | Dentist | 2804 N Oak St, Suite B, Valdosta, GA 31602-1716 | 2006-07-27 |
| 1083017784 | Heather Hyers | Nurse Practitioner | 2804 N Oak St, Valdosta, GA 31602-5914 | 2014-10-08 |
| 1285063842 | Sara Lewis | Clinic/Center | 2804 N Oak St, Ste C, Valdosta, GA 31602-5914 | 2013-11-04 |
| 1508293465 | Destiny Medical Services, Inc | Physical Medicine & Rehabilitation | 2804 N Oak St, Valdosta, GA 31602-5914 | 2013-10-08 |
| 1063521250 | Care Medical Center | Exclusive Provider Organization | 2804 N Oak St, Suite C, Valdosta, GA 31602-1716 | 2006-08-30 |
| 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 | 305R00000X |
| Grouping | Managed Care Organizations |
| Classification | Preferred Provider Organization |
| A group of physicians and/or hospitals who contract with an employer to provide services to their employees. In a PPO, the patient may got to the physician of his/her choice, even if that physician does not participate in the PPO, but the patient receives care at a lower benefit level. |
| Notes: Source: "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/ October 1995, p. 62 |
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| 1659818482 | Three In One Medical | Preferred Provider Organization | 5222 Addison Trl Sw, Lilburn, GA 30047-6670 | 2017-01-31 |
| 1205288164 | Medprime Brookhaven | Preferred Provider Organization | 2 Concourse Pkwy, Suite 100, Atlanta, GA 30328-5371 | 2016-07-04 |
| 1003267352 | New Horizon | Preferred Provider Organization | 6200 Bradley Park Dr, Columbus, GA 31904-3078 | 2016-06-28 |
| 1154796563 | Michelle Woodard M.d LLC | Preferred Provider Organization | 2410 Hog Mountain Rd Ste 303, Watkinsville, GA 30677-4850 | 2015-12-10 |
| 1730553322 | Amanda Kort, LLC | Preferred Provider Organization | 37 West Fairmont Avenue, Savannah, GA 31405 | 2015-11-19 |
| 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.