AZALEA NEURO AND SPINE CLINIC PC (NPI# 1982085197) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1982085197 |
| Entity Type | Organization |
| Organization Name | AZALEA NEURO AND SPINE CLINIC PC |
| Practice Address |
2109 N Patterson St Valdosta GA 31602-2990 |
| Practice Telephone | 2294697271 |
| Practice Fax Number | 8446623122 |
| Mailing Telephone | 2294697271 |
| Mailing Fax Number | 8446623122 |
| Enumeration Date | 2015-06-12 |
| Last Update Date | 2015-11-02 |
| Authorized Official Name | DR. HITHAM KHALIL (OWNER) |
| Authorized Official Telephone | 2294697271 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207T00000X | Neurological Surgery | Allopathic & Osteopathic Physicians |
| Street Address |
2109 N PATTERSON ST |
| City | VALDOSTA |
| State | GA |
| Zip Code | 31602-2990 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790776201 | Linda Ann King | Physical Therapist | 2109 N Patterson St, Suite A, Valdosta, GA 31602-2946 | 2005-11-03 |
| 1942747985 | Kaylyn Harrell | Physical Therapy Assistant | 2109 N Patterson St, Suite #a, Valdosta, GA 31602-2990 | 2017-01-29 |
| 1891099867 | Katherine Freeman | Social Worker | 2109 N Patterson St, Ste B, Valdosta, GA 31602-2577 | 2011-01-05 |
| 1346411725 | Jynger Morris Huling | Counselor | 2109 N Patterson St, Suite B, Valdosta, GA 31602-2990 | 2008-03-13 |
| 1982807871 | Tisha Caroline Kirby | Physical Therapist | 2109 N Patterson St, Ste A, Valdosta, GA 31602-2946 | 2007-06-07 |
| 1467660100 | Ginger D Jackson | Physical Therapy Assistant | 2109 N Patterson St, Ste A, Valdosta, GA 31602-2946 | 2007-05-18 |
| 1124235908 | Jill Whatley | Physical Therapy Assistant | 2109 N Patterson St, Ste A, Valdosta, GA 31602-2946 | 2007-05-17 |
| 1114134988 | Megan L Morris | Specialist/Technologist | 2109 N Patterson St, Ste A, Valdosta, GA 31602-2946 | 2007-05-17 |
| 1518189935 | Joseph Moore | Physical Therapist | 2109 N Patterson St, Suite A, Valdosta, GA 31602-2946 | 2007-05-03 |
| 1578775771 | Valdosta Physical Therapy, Inc | Physical Therapist | 2109 N Patterson St, Suite A, Valdosta, GA 31602-2946 | 2007-05-03 |
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| 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 |
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| Taxonomy Code | 207T00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Neurological Surgery |
| A neurological surgeon provides the operative and non-operative management (i.e., prevention, diagnosis, evaluation, treatment, critical care, and rehabilitation) of disorders of the central, peripheral, and autonomic nervous systems, including their supporting structures and vascular supply; the evaluation and treatment of pathological processes which modify function or activity of the nervous system; and the operative and non-operative management of pain. A neurological surgeon treats patients with disorders of the nervous system; disorders of the brain, meninges, skull, and their blood supply, including the extracranial carotid and vertebral arteries; disorders of the pituitary gland; disorders of the spinal cord, meninges, and vertebral column, including those which may require treatment by spinal fusion or instrumentation; and disorders of the cranial and spinal nerves throughout their distribution. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added] Additional Resources: American Board of Neurological Surgery, 2007. http://www.abns.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Neurological Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821189408 | Hitham H Khalil | Neurological Surgery | 2109 N Patterson St Ste B, Valdosta, GA 31602-2577 | 2006-09-27 |
| 1619089125 | Edward K Mark Jr. | Neurological Surgery | 4274 N Valdosta Rd, Valdosta, GA 31602-6814 | 2006-08-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689275505 | Apex Spine and Neurosurgery LLC | Neurological Surgery | 1295 Hembree Rd Ste 200 Bldg B, Roswell, GA 30076 | 2020-11-06 |
| 1457968372 | Reagan Medical Center | Neurological Surgery | 1295 Hembree Rd Ste 200, Roswell, GA 30076-5721 | 2020-09-24 |
| 1144845116 | Legacy Center for Spinal Surgery, LLC | Neurological Surgery | 1900 The Exchange, Ne, Suite 600, Marietta, GA 30060 | 2020-06-15 |
| 1831720408 | Jonathan Lau | Neurological Surgery | 1365 Clifton Rd Ne Ste B6168, Atlanta, GA 30322-1013 | 2020-01-31 |
| 1528612728 | The Neurological Institute of Savannah & Center for Spine, PC | Neurological Surgery | 101 St Josephs Candler Dr, Pooler, GA 31322-9579 | 2019-07-26 |
| 1770149478 | The Neurological Institute of Savannah & Center for Spine P C | Neurological Surgery | 2a Ed Moore Ct, Statesboro, GA 30458-5024 | 2019-05-17 |
| 1740758358 | Allspine Surgery Center-2 LLC | Neurological Surgery | 1944 Clairmont Rd, Decatur, GA 30033-3406 | 2018-11-13 |
| 1427531268 | Robert Burney II | Neurological Surgery | 101 Lakeview Dr, Hamilton, GA 31811-4365 | 2018-09-07 |
| 1558878884 | Tattnall Hospital Company, LLC | Neurological Surgery | 242 Industrial Blvd, Dublin, GA 31021 | 2018-01-09 |
| 1942727425 | The Neurological Institute of Savannah & Center for Spine P C | Neurological Surgery | 1805 Manning Dr, Vidalia, GA 30474-8921 | 2017-08-25 |
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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.