John Casey Spivey (NPI# 1659517811, PAC ID# 5294962783) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is ORTHOPEDIC SURGERY.
| Nation Provider ID (NPI) | 1659517811 |
| PAC ID by PECOS | 5294962783 |
| Professional Enrollment ID | I20170808002938 |
| Full Name | John Casey Spivey |
| Organization Legal Name | MARK SPIVEY ORTHOPEDIC CLINIC LLC |
| Address |
3301 1st St E Suite A Vidalia GA 30474 |
| Phone Number | 9125374411 |
| Gender | M |
| Medical School | MERCER UNIVERSITY SCHOOL OF MEDICINE |
| Graduation Year | 2012 |
| Primary Specialty | ORTHOPEDIC SURGERY |
| Secondary Specialties | SPORTS MEDICINE |
| Group Practice PAC ID | 5395797336 |
| Number of Group Practice Members | 4 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 111323 | OPTIM MEDICAL CENTER - TATTNALL |
| 110128 | MEADOWS REGIONAL MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 230 Industrial Blvd, Dublin, GA 31021-2904 | 4782723140 | MARK SPIVEY ORTHOPEDIC CLINIC LLC |
| 16915 Ga Hwy 67 A, Statesboro, GA 30458-5819 | 9126812500 | TATTNALL HOSPITAL COMPANY LLC |
| 3301 1st St E, Suite A, Vidalia, GA 30474 | 9125374411 | MARK SPIVEY ORTHOPEDIC CLINIC LLC |
| 3301 E 1st St, Suite B, Vidalia, GA 30474-8674 | 9126445303 | TATTNALL HOSPITAL COMPANY LLC |
| Organization Legal Name | MARK SPIVEY ORTHOPEDIC CLINIC LLC |
| Physicians | 4 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Archie J Champion | Physician Assistant | Mark Spivey Orthopedic Clinic LLC | 3301 1st St E, Suite A, Vidalia, GA 30474 |
| Charles M Spivey | Orthopedic Surgery | Mark Spivey Orthopedic Clinic LLC | 3301 1st St E, Suite A, Vidalia, GA 30474 |
| Richard M Proenza | Physician Assistant | Mark Spivey Orthopedic Clinic LLC | 3301 1st St E, Suite A, Vidalia, GA 30474 |
| Street Address |
3301 1ST ST E SUITE A |
| City | VIDALIA |
| State | GA |
| Zip | 30474 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Archie J Champion | Physician Assistant | Mark Spivey Orthopedic Clinic LLC | 3301 1st St E, Suite A, Vidalia, GA 30474 |
| Charles M Spivey | Orthopedic Surgery | Mark Spivey Orthopedic Clinic LLC | 3301 1st St E, Suite A, Vidalia, GA 30474 |
| Richard M Proenza | Physician Assistant | Mark Spivey Orthopedic Clinic LLC | 3301 1st St E, Suite A, Vidalia, GA 30474 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Karen Pamela Mcneely | Nurse Practitioner | Peterson Dermatology, P.C. | 305 1st St W, Vidalia, GA 30474 |
| David H Paine | Internal Medicine | 1006 A Mt Vernon Rd, Vidalia, GA 30474 | |
| Walter J Revell Jr. | General Surgery | Peterson Dermatology, P.C. | 305 1st St W, Vidalia, GA 30474 |
| Letty Revell Peterson | Dermatology | Peterson Dermatology, P.C. | 305 1st St W, Vidalia, GA 30474 |
| Paul J Giles | Cardiovascular Disease (cardiology) | Paul Joseph Giles Md LLC | 1006 Mount Vernon Rd, Vidalia, GA 30474-3029 |
| Robert Andrew Bell | Nurse Practitioner | Paul Joseph Giles Md LLC | 1006 Mount Vernon Rd, Vidalia, GA 30474-3029 |
| Jeanie L Allen | Nurse Practitioner | Paul Joseph Giles Md LLC | 1006 Mount Vernon Rd, Vidalia, GA 30474-3029 |
| Terra Hardeman | Nurse Practitioner | Paul Joseph Giles Md LLC | 1006 Mount Vernon Rd, Vidalia, GA 30474-3029 |
| Ramachand R Paidi | Neuropsychiatry | 106 Queen St, 1a, Vidalia, GA 30474-4210 | |
| Lewis R Collins Jr. | Dermatology | Lewis R. Collins, Jr., M.d., P. C. | 1013 E 1st St, Vidalia, GA 30474-4227 |
| Find all physicians in zip 30474 | |||
| City | VIDALIA |
| Zip Code | 30474 |
| Specialty | ORTHOPEDIC SURGERY |
| City + Specialty | VIDALIA + ORTHOPEDIC SURGERY |
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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.