Archie J Champion (NPI# 1710944681, PAC ID# 8224104211) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is PHYSICIAN ASSISTANT.
| Nation Provider ID (NPI) | 1710944681 |
| PAC ID by PECOS | 8224104211 |
| Professional Enrollment ID | I20080827000192 |
| Full Name | Archie J Champion |
| Organization Legal Name | MARK SPIVEY ORTHOPEDIC CLINIC LLC |
| Address |
3301 1st St E Suite A Vidalia GA 30474 |
| Phone Number | 9125374411 |
| Gender | M |
| Graduation Year | 2001 |
| Primary Specialty | PHYSICIAN ASSISTANT |
| Group Practice PAC ID | 5395797336 |
| Number of Group Practice Members | 4 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 110128 | MEADOWS REGIONAL MEDICAL CENTER |
| 110125 | FAIRVIEW PARK HOSPITAL |
| 111323 | OPTIM MEDICAL CENTER - TATTNALL |
| Address | Phone | Organization |
|---|---|---|
| 230 Industrial Blvd, Dublin, GA 31021-2904 | 4782723140 | MARK SPIVEY ORTHOPEDIC CLINIC LLC |
| 242 Industrial Blvd, Dublin, GA 31021-2904 | 4782723140 | MARK SPIVEY ORTHOPEDIC CLINIC LLC |
| 3301 1st St E, Suite A, Vidalia, GA 30474 | 9125374411 | MARK SPIVEY ORTHOPEDIC CLINIC LLC |
| Measure Identifier | Measure Title | Performance Rate | Reporting Mechanism |
|---|---|---|---|
| ACI_EC_TRANS_EP_1 | e-Prescribing | 1% | |
| ACI_EC_TRANS_HIE_1 | Health Information Exchange | 11% | |
| ACI_EC_TRANS_MR_1 | Medication Reconciliation | 87% | |
| ACI_EC_TRANS_PEA_1 | Provide Patient Access | 42% | |
| ACI_EC_TRANS_PEA_2 | View, Download, or Transmit (VDT) | 2% | |
| ACI_EC_TRANS_PPHI_1 | Security Risk Analysis | % | |
| ACI_EC_TRANS_PSE_1 | Patient-Specific Education | 33% | |
| ACI_EC_TRANS_SM_1 | Secure Messaging | 2% |
| Organization Legal Name | MARK SPIVEY ORTHOPEDIC CLINIC LLC |
| Physicians | 4 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| John Casey Spivey | Orthopedic Surgery | 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 |
|---|---|---|---|
| John Casey Spivey | Orthopedic Surgery | 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 | PHYSICIAN ASSISTANT |
| City + Specialty | VIDALIA + PHYSICIAN ASSISTANT |
Please comment or provide details below to improve the information on Archie J Champion.
| 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.