SOUTHERN HEALTHCARE ALLIANCE, LLC (NPI# 1962991703) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962991703 |
| Entity Type | Organization |
| Organization Name | SOUTHERN HEALTHCARE ALLIANCE, LLC |
| Other Organization Name | SOUTHERN NEUROLOGY, PHYSICAL MEDICINE & REHABILITATION |
| Practice Address |
101-f W. Northside Drive Valdosta GA 31602 |
| Practice Telephone | 2292621981 |
| Practice Fax Number | 2293750392 |
| Mailing Telephone | 2292621981 |
| Mailing Fax Number | 2293750392 |
| Enumeration Date | 2018-05-08 |
| Last Update Date | 2020-08-12 |
| Authorized Official Name | SHERI L SWADER (PHYSICIAN/OWNER) |
| Authorized Official Telephone | 2292621981 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208100000X | Physical Medicine & Rehabilitation | Allopathic & Osteopathic Physicians | ||
| Y | 2084N0400X |
Psychiatry & Neurology Specialization: Neurology |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 003229819A | 05 | |
| GA | 003208546C | 05 |
| Other Name | Type Code |
|---|---|
| Southern Healthcare Alliance, LLC | Doing Business As Name - Organization |
| Southern Neurology, Physical Medicine & Rehabilitation | Doing Business As Name - Organization |
| Street Address |
101-F W. NORTHSIDE DRIVE |
| City | VALDOSTA |
| State | GA |
| Zip Code | 31602 |
| 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 |
| 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 |
| 1952701641 | Alan Vega | Military Health Care Provider | 3715 N Valdosta Rd Apt 82, Valdosta, GA 31602 | 2014-08-29 |
| Find all providers in zip 31602 | ||||
| Taxonomy Code | 2084N0400X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Neurology |
| A Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013544899 | Southern Neurology, Physical Medicine & Rehabilitation, LLC | Psychiatry & Neurology | 4913 Lanes Pond Rd, Valdosta, GA 31601-1537 | 2020-03-24 |
| 1811342561 | The Migraine and Spine Clinic of Valdosta LLC | Psychiatry & Neurology | 3315 N Valdosta Rd, Suite A, Valdosta, GA 31602-1107 | 2016-05-02 |
| 1376783811 | P. Edwards Conrad Md. P.C. | Psychiatry & Neurology | 2935 N Ashley St Ste D-116, Valdosta, GA 31602-1788 | 2009-02-24 |
| 1932384260 | Jonathan Alex Sule Sr. | Psychiatry & Neurology | 3790 Old U.S. Hwy 41 North, Suite B, Valdosta, GA 31602-1398 | 2008-01-06 |
| 1184606824 | Mahmood Sayied Eisa | Psychiatry & Neurology | 4274 N Valdosta Rd, Valdosta, GA 31602-6814 | 2005-11-17 |
| 1194706911 | Sheri L Swader | Psychiatry & Neurology | 101f W Northside Dr, Valdosta, GA 31602-1700 | 2005-11-09 |
| 1720074602 | Penelope Edwards-conrad | Psychiatry & Neurology | 2935 N Ashley St, D116, Valdosta, GA 31602-1777 | 2005-09-26 |
| 1578605259 | Steven Brian Dawson | Psychiatry & Neurology | 2501 N Patterson St, Valdosta, GA 31602-1735 | 2007-02-12 |
| 1689786055 | Hernan N Posas Jr. | Psychiatry & Neurology | 4274 N Valdosta Rd, Valdosta, GA 31602-6814 | 2006-08-31 |
| 1356453914 | Bipin R Patel | Psychiatry & Neurology | 4274 N Valdosta Rd, Valdosta, GA 31602-6814 | 2006-08-31 |
| 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.