Edie E Willis (NPI# 1356877328, PAC ID# 4880962778) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is PHYSICIAN ASSISTANT.
| Nation Provider ID (NPI) | 1356877328 |
| PAC ID by PECOS | 4880962778 |
| Professional Enrollment ID | I20170619000387 |
| Full Name | Edie E Willis |
| Organization Legal Name | NEPHROLOGY MEDICAL ASSOCIATES OF GEORGIA, LLC |
| Address |
259 Us Hwy 19 N Camilla GA 31730-1410 |
| Phone Number | 2292271229 |
| Gender | F |
| Graduation Year | 2017 |
| Primary Specialty | PHYSICIAN ASSISTANT |
| Group Practice PAC ID | 5991600629 |
| Number of Group Practice Members | 23 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 110105 | COLQUITT REGIONAL MEDICAL CENTER |
| 110038 | JOHN D ARCHBOLD MEMORIAL HOSPITAL |
| 111332 | BROOKS COUNTY HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 259 Us Hwy 19 N, Camilla, GA 31730-1410 | 2292271229 | NEPHROLOGY MEDICAL ASSOCIATES OF GEORGIA, LLC |
| 334 Smith Ave, Thomasville, GA 31792-5533 | 2292271595 | NEPHROLOGY MEDICAL ASSOCIATES OF GEORGIA, LLC |
| Organization Legal Name | NEPHROLOGY MEDICAL ASSOCIATES OF GEORGIA, LLC |
| Physicians | 22 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Reginald H Joseph | Nephrology | Nephrology Medical Associates of Georgia, LLC | 10333 Southpoint Landing Blvd, Suite 161, Fredericksburg, VA 22407-8042 |
| Deuel C Mcelreath | Physician Assistant | Nephrology Medical Associates of Georgia, LLC | 259 Us Hwy 19 N, Camilla, GA 31730-1410 |
| Mamatha Gandhi | Internal Medicine | Nephrology Medical Associates of Georgia, LLC | 3570 Grandview Pkwy, Suite 101, Birmingham, AL 35243-2065 |
| Raul G Santos | Nephrology | Nephrology Medical Associates of Georgia, LLC | 334 Smith Ave, Thomasville, GA 31792-5533 |
| Catherine W Howell | Physician Assistant | Nephrology Medical Associates of Georgia, LLC | 259 Us Hwy 19 N, Camilla, GA 31730-1410 |
| Clayton Darley | Nurse Practitioner | Nephrology Medical Associates of Georgia, LLC | 334 Smith Ave, Thomasville, GA 31792-5533 |
| Usman Rahmat | Nephrology | Nephrology Medical Associates of Georgia, LLC | 10333 Southpoint Landing Blvd, Suite 161, Fredericksburg, VA 22407-8042 |
| Sara F Searcy | Nurse Practitioner | Nephrology Medical Associates of Georgia, LLC | 334 Smith Ave, Thomasville, GA 31792-5533 |
| Charles J Baker | Physician Assistant | Nephrology Medical Associates of Georgia, LLC | 259 Us Hwy 19 N, Camilla, GA 31730-1410 |
| Daryl O Crenshaw | Nephrology | Nephrology Medical Associates of Georgia, LLC | 334 Smith Ave, Thomasville, GA 31792-5533 |
| Street Address |
259 US HWY 19 N |
| City | CAMILLA |
| State | GA |
| Zip | 31730-1410 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Deuel C Mcelreath | Physician Assistant | Nephrology Medical Associates of Georgia, LLC | 259 Us Hwy 19 N, Camilla, GA 31730-1410 |
| Catherine W Howell | Physician Assistant | Nephrology Medical Associates of Georgia, LLC | 259 Us Hwy 19 N, Camilla, GA 31730-1410 |
| Charles J Baker | Physician Assistant | Nephrology Medical Associates of Georgia, LLC | 259 Us Hwy 19 N, Camilla, GA 31730-1410 |
| Amanda D May | Internal Medicine | Archbold Medical Group, Inc. | 259 Us Hwy 19 N, Camilla, GA 31730-1410 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Raymond J Otis Sr. | Family Medicine | 24 N Ellis St, Camilla, GA 31730-1502 | |
| Michael S Shiver | Physical Therapy | Flint River Physical Therapy | 130 E Broad St, Camilla, GA 31730-1809 |
| Donald C Brunelle | Physical Therapy | Flint River Physical Therapy | 130 E Broad St, Camilla, GA 31730-1809 |
| Melissa M Ellis | Physical Therapy | Flint River Physical Therapy | 130 E Broad St, Camilla, GA 31730-1809 |
| Muhammad A Khan | Internal Medicine | Southland Bainbridge Hospitalist Group LLC | 90 E Stephens St, Camilla, GA 31730-1836 |
| James L Pritchett | Optometry | 162 E Broad St, Camilla, GA 31730-1841 | |
| Christine M Lockhart | Nurse Practitioner | Hospital Authority of Mitchell County | 90 Stevens St, Camilla, GA 31730-1899 |
| Savitri Ramdial | Family Medicine | Hospital Authority of Mitchell County | 90 Stevens St, Camilla, GA 31730-1899 |
| Stephen Allen Rubendall Jr. | Family Medicine | Hospital Authority of Mitchell County | 90 Stevens St, Camilla, GA 31730-1899 |
| Melissa Pollock Anderson | Nurse Practitioner | Hospital Authority of Mitchell County | 90 Stevens St, Camilla, GA 31730-1899 |
| Find all physicians in zip 31730 | |||
| City | CAMILLA |
| Zip Code | 31730 |
| Specialty | PHYSICIAN ASSISTANT |
| City + Specialty | CAMILLA + PHYSICIAN ASSISTANT |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.