| Georgia Pines Community Service Board | |
|
1102 Smith Ave Thomasville GA 31792-5739 | |
| (229) 225-4335 | |
| (229) 225-4374 |
| Full Name | Georgia Pines Community Service Board |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 1102 Smith Ave, Thomasville, Georgia |
| Authorized Official Name and Position | Robert H Jones (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 2292254373 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Georgia Pines Community Service Board 1102 Smith Ave Thomasville GA 31792-5739 Ph: (229) 225-4335 | Georgia Pines Community Service Board 1102 Smith Ave Thomasville GA 31792-5739 Ph: (229) 225-4335 |
| NPI Number | 1366506958 |
|---|---|
| Provider Enumeration Date | 12/20/2006 |
| Last Update Date | 01/25/2008 |
| Medicare PECOS PAC ID | 5799772844 |
|---|---|
| Medicare Enrollment ID | O20040429000631 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366506958 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Lisa A Rudolph-watson |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1881627867 PECOS PAC ID: 0941293963 Enrollment ID: I20040406000711 |
| Provider Name | Calvin J Reams |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1427131101 PECOS PAC ID: 7315924073 Enrollment ID: I20040701000515 |
| Provider Name | Abdul Bari |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1659324994 PECOS PAC ID: 2567430150 Enrollment ID: I20040921001196 |
| Provider Name | Michelle B Fan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437272796 PECOS PAC ID: 6204896988 Enrollment ID: I20041018000054 |
| Provider Name | Carmen D Turner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144473604 PECOS PAC ID: 1850349549 Enrollment ID: I20050110000561 |
| Provider Name | James A Thompson |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1558389940 PECOS PAC ID: 7618906157 Enrollment ID: I20051031000516 |
| Provider Name | Jeremy W Poole |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1548343593 PECOS PAC ID: 0143278192 Enrollment ID: I20060315000671 |
| Provider Name | Briccio Dizon Valdez |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1801806443 PECOS PAC ID: 4385648187 Enrollment ID: I20060911000201 |
| Provider Name | Denise M Atkinson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669577292 PECOS PAC ID: 0547354326 Enrollment ID: I20070925000047 |
| Provider Name | Jonathan Steven Williams |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1346391299 PECOS PAC ID: 6507954799 Enrollment ID: I20071126000151 |
| Provider Name | Mark Lee |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1619028255 PECOS PAC ID: 7113004524 Enrollment ID: I20080409000740 |
| Provider Name | James D Drury |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1467632851 PECOS PAC ID: 1456420264 Enrollment ID: I20080520000566 |
| Provider Name | Eric M Lehman |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1689611618 PECOS PAC ID: 8022176601 Enrollment ID: I20081027000246 |
| Provider Name | Timothy O Thomson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1699858605 PECOS PAC ID: 8527006568 Enrollment ID: I20090630000145 |
| Provider Name | Eugene Y Sun |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1730398496 PECOS PAC ID: 9638221161 Enrollment ID: I20090715000108 |
| Provider Name | Diahann Meekins Moore |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1669707956 PECOS PAC ID: 3678611860 Enrollment ID: I20091109000394 |
| Provider Name | Bonny S Voyles |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851627624 PECOS PAC ID: 8022157593 Enrollment ID: I20091124000046 |
| Provider Name | Amy E Geer |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1528141553 PECOS PAC ID: 2163460197 Enrollment ID: I20100308000066 |
| Provider Name | Charles R Sanders |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1144303124 PECOS PAC ID: 4981642923 Enrollment ID: I20100308000107 |
| Provider Name | Daniel B. Wright |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932435294 PECOS PAC ID: 1759417462 Enrollment ID: I20100406000484 |
| Provider Name | Mark G Wood |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1427152958 PECOS PAC ID: 7719045897 Enrollment ID: I20101124000536 |
| Provider Name | Michael Forehand |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730133521 PECOS PAC ID: 4183627391 Enrollment ID: I20110426000580 |
| Provider Name | Martha Nelly Millan Sanchez |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1396953246 PECOS PAC ID: 9436312014 Enrollment ID: I20120517000432 |
| Provider Name | Thomas Eugene Edwards |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1558599159 PECOS PAC ID: 1658536842 Enrollment ID: I20120714000053 |
| Provider Name | Nayyer Iqbal |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1437291994 PECOS PAC ID: 6901997204 Enrollment ID: I20120807000835 |
| Provider Name | Glendell B Coleman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962755421 PECOS PAC ID: 4688826514 Enrollment ID: I20121128000649 |
| Provider Name | Sherry Mccoy |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1861745994 PECOS PAC ID: 8729220231 Enrollment ID: I20130813000717 |
| Provider Name | Sheryl A Stoyle |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356747570 PECOS PAC ID: 7315263100 Enrollment ID: I20150314000139 |
| Provider Name | Stanley Soles |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750790465 PECOS PAC ID: 3779800834 Enrollment ID: I20150330001084 |
| Provider Name | Justin W Anderson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023494135 PECOS PAC ID: 4486960168 Enrollment ID: I20150825005525 |
| Provider Name | Rainey Sellers Williams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144610031 PECOS PAC ID: 0840510673 Enrollment ID: I20151211001199 |
| Provider Name | Michael Barrow |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497111207 PECOS PAC ID: 2062716723 Enrollment ID: I20160202001326 |
| Provider Name | Keywanna Nichole Price |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588020234 PECOS PAC ID: 8123317252 Enrollment ID: I20160512002200 |
| Provider Name | Lori A Dixon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467819102 PECOS PAC ID: 2264723923 Enrollment ID: I20160628000637 |
| Provider Name | Jessica N Battle |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700254364 PECOS PAC ID: 8022305721 Enrollment ID: I20160923000771 |
| Provider Name | Robin Belcher-howard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104292200 PECOS PAC ID: 9537439088 Enrollment ID: I20180601001772 |
| Provider Name | Sherri F Mcbrayer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386149730 PECOS PAC ID: 2769738228 Enrollment ID: I20180713000740 |
| Provider Name | Shelby L Elder |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205333424 PECOS PAC ID: 4183973357 Enrollment ID: I20180821002553 |
| Provider Name | Lisa M Harris |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609395110 PECOS PAC ID: 1456601269 Enrollment ID: I20180828004172 |
| Provider Name | Megan W Alligood |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225534670 PECOS PAC ID: 9335499292 Enrollment ID: I20180913003429 |
| Provider Name | Kristina Abt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962993519 PECOS PAC ID: 8123372315 Enrollment ID: I20181106001749 |
| Provider Name | Vashawn Mosley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679069231 PECOS PAC ID: 7719226596 Enrollment ID: I20190222002524 |
| Provider Name | Tremeze Jackson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477076792 PECOS PAC ID: 7618204918 Enrollment ID: I20190808003981 |
| Provider Name | Jessica Oliver |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114585940 PECOS PAC ID: 5597095034 Enrollment ID: I20190925002258 |
| Provider Name | Yetnayet B Tessema |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306301866 PECOS PAC ID: 9234562307 Enrollment ID: I20191203001761 |
| Provider Name | Jonathan Walker |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1306116157 PECOS PAC ID: 6901232768 Enrollment ID: I20200214001367 |
| Provider Name | April Monika Washington |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104441039 PECOS PAC ID: 3072931724 Enrollment ID: I20200914000744 |
| Provider Name | Richard Soper |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1386246965 PECOS PAC ID: 9830598978 Enrollment ID: I20210524000350 |
| Provider Name | Yolanda R Williams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093339319 PECOS PAC ID: 1456743954 Enrollment ID: I20220112002854 |
| Provider Name | Jerusha L Stacey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114512746 PECOS PAC ID: 0941640510 Enrollment ID: I20240430001036 |
| Provider Name | Jillian C Martell |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1306696265 PECOS PAC ID: 6002257847 Enrollment ID: I20240510003259 |
| Provider Name | Courtnay K Perryman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003697103 PECOS PAC ID: 9931541158 Enrollment ID: I20240520002808 |
Graves Psychological Services Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 319 N Stevens St, Thomasville, GA 31792 Phone: 229-221-3442 Fax: 855-560-7664 | |
Georgia Pines Community Service Board Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 367 Shoreline Dr, Apt A&b, Thomasville, GA 31757 Phone: 229-225-4335 Fax: 229-225-4374 | |
Georgia Pines Community Service Board Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 14244 Us Highway 19 S, Thomasville, GA 31757 Phone: 229-225-4335 Fax: 229-225-4374 | |
Southwest Community Clinic Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 400 S Pinetree Blvd, Thomasville, GA 31792 Phone: 229-227-2990 Fax: 229-225-4052 | |
Georgia Pines Community Service Board Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 407 Cloverdale Drive, Thomasville, GA 31792 Phone: 229-233-8904 | |
Crossing Jordan Counseling Services, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 125 N Broad St Ste 302, Thomasville, GA 31792 Phone: 912-212-5803 Fax: 229-512-3767 | |
Georgia Pines Community Service Board Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1102 Smith Ave, Thomasville, GA 31792 Phone: 229-225-4335 Fax: 229-225-4374 |