Valdosta Family Medicine - Medicare in Valdosta, GA

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Valdosta Family Medicine is a medicare enrolled "Family Medicine" provider in Valdosta, Georgia. Their current practice location is 2412 N Oak St, Valdosta, Georgia. You can reach out to their office (for appointments etc.) via phone at (229) 244-1400.

Valdosta Family Medicine is licensed to practice in Georgia (license number 045725) and it also participates in the medicare program. Valdosta Family Medicine is enrolled with medicare and should accept medicare assignments and since they are enrolled in medicare, they may order Medicare Part D Prescription drugs, if eligible. The facility's NPI Number is 1114003779.

Contact Information

Valdosta Family Medicine
2412 N Oak St,
Valdosta, GA 31602-2567
(229) 244-1400
(229) 244-5512

Map and Direction




Healthcare Provider's Profile

Full NameValdosta Family Medicine
TypeFacility
SpecialityFamily Medicine
Location2412 N Oak St, Valdosta, Georgia
Accepts Medicare AssignmentsMedicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1114003779
  • Provider Enumeration Date: 10/27/2006
  • Last Update Date: 12/28/2021
  Medicare PECOS Information:
  • PECOS PAC ID: 5991791683
  • Enrollment ID: O20040420001241

Medical Identifiers

Medical identifiers for Valdosta Family Medicine such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1114003779NPI-NPPES
GRP1391OtherGAMEDICARE
55001045AMedicaidGA

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
111N00000XChiropractor CHIRO02539 (Georgia)Secondary
207Q00000XFamily Medicine 045725 (Georgia)Primary
207Q00000XFamily Medicine 029930 (Georgia)Secondary
207Q00000XFamily Medicine 029951 (Georgia)Secondary
207Q00000XFamily Medicine 030242 (Georgia)Secondary
207RE0101XInternal Medicine - Endocrinology, Diabetes & Metabolism 044001 (Georgia)Secondary
207RG0100XInternal Medicine - Gastroenterology 041290 (Georgia)Secondary
207RR0500XInternal Medicine - Rheumatology 041978 (Georgia)Secondary
207Y00000XOtolaryngology 008563 (Georgia)Secondary
363A00000XPhysician Assistant 003072 (Georgia)Secondary
363A00000XPhysician Assistant 004849 (Georgia)Secondary
363A00000XPhysician Assistant 004094 (Georgia)Secondary
363LF0000XNurse Practitioner - Family RN154901 (Georgia)Secondary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Valdosta Family Medicine acts as a billing entity for following providers:
Provider NameJennifer E Lawrence
Provider TypePractitioner - Endocrinology
Provider IdentifiersNPI Number: 1396827457
PECOS PAC ID: 2769470400
Enrollment ID: I20040503000973
Provider NameKimberly S Snow
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1730308883
PECOS PAC ID: 9830147297
Enrollment ID: I20050112000376
Provider NameLeon F Smith
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1841372653
PECOS PAC ID: 9638081821
Enrollment ID: I20050727000939
Provider NameBrandy R Van Jura
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1124108410
PECOS PAC ID: 9436155181
Enrollment ID: I20061020000036
Provider NameDavid M Pierce
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1245312057
PECOS PAC ID: 1850389545
Enrollment ID: I20080917000293
Provider NameCraig E Bishop
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1679655492
PECOS PAC ID: 5991793697
Enrollment ID: I20080918000364
Provider NameStewart A Williams
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1437231255
PECOS PAC ID: 8820086507
Enrollment ID: I20081003000459
Provider NameWilliam C Tidmore
Provider TypePractitioner - Rheumatology
Provider IdentifiersNPI Number: 1073695292
PECOS PAC ID: 5294723987
Enrollment ID: I20081003000506
Provider NameTracy C Creed
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1912157272
PECOS PAC ID: 6901920396
Enrollment ID: I20100908000579
Provider NameMatthew A Thomas
Provider TypePractitioner - Physician Assistant
Provider IdentifiersNPI Number: 1093759011
PECOS PAC ID: 8921272824
Enrollment ID: I20111110000362
Provider NameAndrea P Krispin
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1487927836
PECOS PAC ID: 9133380413
Enrollment ID: I20120412000703
Provider NamePollyanna Marie Boykin
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1811018153
PECOS PAC ID: 7517187008
Enrollment ID: I20141209001343
Provider NameRobert D Bennett
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1023456290
PECOS PAC ID: 1759682271
Enrollment ID: I20151229000051
Provider NameJessica Taylor
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1831607670
PECOS PAC ID: 1052668274
Enrollment ID: I20180719001262
Provider NameTimothy Blake Taylor
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1356847743
PECOS PAC ID: 2769732288
Enrollment ID: I20180904003293
Provider NameJordan Ganas
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1972093185
PECOS PAC ID: 8527310846
Enrollment ID: I20181015000327
Provider NameAnna C Vaggalis
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1558846121
PECOS PAC ID: 1951649698
Enrollment ID: I20190205002185
Provider NameLindsey Lawhorn
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1992335855
PECOS PAC ID: 6204264641
Enrollment ID: I20200317002041
Provider NameSarah Goodman Fender
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1447821129
PECOS PAC ID: 2961807714
Enrollment ID: I20210817003970
Provider NameJessica J White
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1659877579
PECOS PAC ID: 4486904166
Enrollment ID: I20211014002009
Provider NameJennifer L White
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1396400859
PECOS PAC ID: 6204225360
Enrollment ID: I20211110002007
Provider NameKarly Bishop
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1396163150
PECOS PAC ID: 4082938733
Enrollment ID: I20220126000016
Provider NameKerri Antonoplos
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1689322596
PECOS PAC ID: 1355736869
Enrollment ID: I20220321000968
Provider NameSaif Munther Za'al Al Borgan
Provider TypePractitioner - Endocrinology
Provider IdentifiersNPI Number: 1346762606
PECOS PAC ID: 4486085057
Enrollment ID: I20220617000038
Provider NameTessa Ashlyn Hancock
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1346996048
PECOS PAC ID: 0042690802
Enrollment ID: I20220711002006
Provider NameChristopher Poore
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1871220525
PECOS PAC ID: 7315322112
Enrollment ID: I20220914003668
Provider NameHunter L Clanton
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1447967575
PECOS PAC ID: 9032587266
Enrollment ID: I20221119000530
Provider NameKayla Schroepfer
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1679284020
PECOS PAC ID: 9335518067
Enrollment ID: I20221219002812
Provider NameGary-wayne Luke Collins
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1164205183
PECOS PAC ID: 1254794142
Enrollment ID: I20230824003053
Provider NameKimberly Davis Bennett
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1457036857
PECOS PAC ID: 5991168304
Enrollment ID: I20230901001967

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Valdosta Family Medicine is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Valdosta Family Medicine
2412 N Oak St,
Valdosta, GA 31602-2567

Ph: (229) 244-1400		Valdosta Family Medicine
2412 N Oak St,
Valdosta, GA 31602-2567

Ph: (229) 244-1400

Reviews and Comments



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Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

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