PORT MEDICAL MANAGEMENT INC (NPI# 1932731361) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1932731361 |
| Entity Type | Organization |
| Organization Name | PORT MEDICAL MANAGEMENT INC |
| Other Organization Name | THE BRIDGE |
| Practice Address |
920 S West St Bainbridge GA 39819-4581 |
| Mailing Address |
922 S West St Bainbridge GA 39819-4581 |
| Practice Telephone | 2294000498 |
| Mailing Telephone | 2292488499 |
| Enumeration Date | 2020-02-04 |
| Last Update Date | 2020-02-05 |
| Authorized Official Name | JENNIFER MOORE (OFFICE MANAGER) |
| Authorized Official Telephone | 2294000498 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
Physician Assistants & Advanced Practice Nursing Providers | ||
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | FAMILY PRACTICE | 1013306547 | 01 |
| GA | FAMILY PRACTICE | 1174851745 | 01 |
| GA | FAMILY PRACTICE | 1972570943 | 01 |
| Other Name | Type Code |
|---|---|
| THE BRIDGE | Doing Business As Name - Organization |
| Street Address |
920 S WEST ST |
| City | BAINBRIDGE |
| State | GA |
| Zip Code | 39819-4581 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841455599 | Dayna Malia Watson | Counselor | 410 West St., Bainbridge, GA 39819 | 2008-07-22 |
| 1740324342 | Jack Hobson Leverett Sr. | Dentist | 1515 Miluli Ave, Bainbridge, GA 39819 | 2007-02-16 |
| 1033212634 | Primary Care Inc | Family Medicine | 315 S Blvd Dr, Bainbridge, GA 39819 | 2006-09-07 |
| 1326060187 | Donald Ray Robinson | Obstetrics & Gynecology | 1501 E Miluli Avenue, Bainbridge, GA 39819 | 2006-07-24 |
| 1255385126 | Linda Jones | Emergency Medicine | 1500 E. Shotwell St., Memorial Hospital & Manor, Bainbridge, GA 39819 | 2006-05-22 |
| 1962464578 | Lillian Ann Crews | Physical Therapy Assistant | 713 East Shotwell St, Bainbridge, GA 39819 | 2006-04-06 |
| 1134181738 | Rachel S Lauder | Physical Therapist | 713 E Shotwell Street, Bainbridge, GA 39819 | 2006-04-06 |
| 1275012015 | Lisa J Sellers | Nurse Practitioner | 509 Wheat Ave, Bainbridge, GA 39819 | 2018-08-13 |
| 1588186324 | Hospital Authority of The City of Bainbridge and Decatur County | Pharmacy | 1500 East Shotwell Street, Bainbridge, GA 39819 | 2017-07-13 |
| 1861531915 | Burke & Robinson Md PC | Obstetrics & Gynecology | 1501 E Miluli Avenue, Bainbridge, GA 39819 | 2007-02-05 |
| Find all providers in zip 39819 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, 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 Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942850755 | Carehere LLC | Family Medicine | Carehere Clinic- Scioto Advantage North, 7454 Us Highway 50w, Bainbridge, OH 45612 | 2019-09-13 |
| 1598920951 | Omar Al Haddad | Family Medicine | 1512 E Evans St, Memorial Hospital and Manor, Bainbridge, GA 39819-4364 | 2008-07-25 |
| 1467624056 | Port City Family Medicine, L.L.C. | Family Medicine | 502 Wheat Ave, Bainbridge, GA 39819-4325 | 2008-03-24 |
| 1871673764 | Andrew Maxwell Steinbach | Family Medicine | 12 East Main St, Bainbridge, NY 13733 | 2006-10-16 |
| 1033212634 | Primary Care Inc | Family Medicine | 315 S Blvd Dr, Bainbridge, GA 39819 | 2006-09-07 |
| 1982676060 | Khalid Rashid Butt | Family Medicine | 12 E Main St, Bainbridge, NY 13733-1221 | 2006-02-03 |
| 1831189984 | Gloria Browne | Family Medicine | 505 Amelia Ave, Bainbridge, GA 39819-4355 | 2005-10-28 |
| 1700885464 | Joyce A. Heald | Family Medicine | 1152 E Us Highway 36, Bainbridge, IN 46105-9604 | 2005-07-15 |
| 1851884068 | Zacharey Alan Powell | Family Medicine | 1500 E Shotwell St, Bainbridge, GA 39819-4256 | 2018-06-12 |
| 1972570943 | Darrell Shawn Surratt | Family Medicine | 603 Wheat Ave, Suite 700, Bainbridge, GA 39819-4360 | 2006-03-08 |
| Find all providers in BAINBRIDGE | ||||
| City | BAINBRIDGE |
| Zip Code | 39819 |
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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.