| Archbold Medical Group, Inc. | |
|
900 Cairo Rd Thomasville GA 31792-4255 | |
| (229) 228-8826 | |
| Not Available |
| Full Name | Archbold Medical Group, Inc. |
|---|---|
| Speciality | Surgery |
| Location | 900 Cairo Rd, Thomasville, Georgia |
| Authorized Official Name and Position | Gregory Hembree (CFO) |
| Authorized Official Contact | 2292282853 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Archbold Medical Group, Inc. 900 Cairo Rd Thomasville GA 31792-4255 Ph: () - | Archbold Medical Group, Inc. 900 Cairo Rd Thomasville GA 31792-4255 Ph: (229) 228-8826 |
| NPI Number | 1831353036 |
|---|---|
| Provider Enumeration Date | 07/16/2008 |
| Last Update Date | 11/04/2020 |
| Medicare PECOS PAC ID | 8123196383 |
|---|---|
| Medicare Enrollment ID | O20081001000632 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831353036 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 207Y00000X | Otolaryngology | (* (Not Available)) | Secondary |
| 208600000X | Surgery | (* (Not Available)) | Primary |
| Provider Name | Matthew B Grundfast |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1124011085 PECOS PAC ID: 8527962869 Enrollment ID: I20031125000517 |
| Provider Name | Joel Quinones |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1215906326 PECOS PAC ID: 8921908104 Enrollment ID: I20040629000887 |
| Provider Name | Jason Griffin |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1063485068 PECOS PAC ID: 8426035015 Enrollment ID: I20040701000796 |
| Provider Name | Kristine E Deutsch |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043215924 PECOS PAC ID: 8325007362 Enrollment ID: I20041006000541 |
| Provider Name | Jong K Davis |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1689733271 PECOS PAC ID: 8527016450 Enrollment ID: I20050107000401 |
| Provider Name | Amanda D May |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1528177623 PECOS PAC ID: 5092765552 Enrollment ID: I20050124000454 |
| Provider Name | Gerald N Kadis |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1942388087 PECOS PAC ID: 9234178427 Enrollment ID: I20050427000732 |
| Provider Name | David C Whitehead |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1962403766 PECOS PAC ID: 7517948573 Enrollment ID: I20050822000427 |
| Provider Name | Geoffrey S Deutsch |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1407835705 PECOS PAC ID: 7214942028 Enrollment ID: I20060215000707 |
| Provider Name | Edward L Hall |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1053390153 PECOS PAC ID: 4688689235 Enrollment ID: I20060217000533 |
| Provider Name | Gregory K Patterson |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1245219534 PECOS PAC ID: 5991711780 Enrollment ID: I20060303000109 |
| Provider Name | Timothy Grayson |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1073597753 PECOS PAC ID: 6608958129 Enrollment ID: I20080123000463 |
| Provider Name | Althea L Grey |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1437143393 PECOS PAC ID: 7517024813 Enrollment ID: I20090331000178 |
| Provider Name | Melissa A Simpson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780826750 PECOS PAC ID: 0244376010 Enrollment ID: I20091008000103 |
| Provider Name | Thomas Edward Dykes |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1710069034 PECOS PAC ID: 3476734252 Enrollment ID: I20110228000245 |
| Provider Name | Josh David Simmons |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1942461132 PECOS PAC ID: 3577740737 Enrollment ID: I20110615000779 |
| Provider Name | Jason M Nesmith |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1881858686 PECOS PAC ID: 8820262728 Enrollment ID: I20120229000222 |
| Provider Name | Dale L Wing |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1720045552 PECOS PAC ID: 1951492610 Enrollment ID: I20120716000045 |
| Provider Name | Lorraine M Williams-rahming |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1386656593 PECOS PAC ID: 4789573171 Enrollment ID: I20130507000394 |
| Provider Name | Jason Odell Burnette |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1467614149 PECOS PAC ID: 2668619305 Enrollment ID: I20130709000740 |
| Provider Name | Rachel A Burns |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497798821 PECOS PAC ID: 0345272233 Enrollment ID: I20130816000435 |
| Provider Name | Johnny M Belenchia |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1205850435 PECOS PAC ID: 8628047610 Enrollment ID: I20140319002071 |
| Provider Name | Esther Tan |
|---|---|
| Provider Type | Practitioner - Medical Oncology |
| Provider Identifiers | NPI Number: 1982754487 PECOS PAC ID: 4688851256 Enrollment ID: I20150512001857 |
| Provider Name | Latarsha L Jones |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114382397 PECOS PAC ID: 3476844838 Enrollment ID: I20160615002318 |
| Provider Name | Michael B Monahan |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1114213428 PECOS PAC ID: 9234421066 Enrollment ID: I20160714000911 |
| Provider Name | Jackson E Hatfield |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1316238744 PECOS PAC ID: 8325264013 Enrollment ID: I20160825002560 |
| Provider Name | Cianna Pender |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1376832261 PECOS PAC ID: 8628366499 Enrollment ID: I20161011000874 |
| Provider Name | Adewole C Longe |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1205994670 PECOS PAC ID: 5496776577 Enrollment ID: I20161228000625 |
| Provider Name | Shay B Schie |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154860625 PECOS PAC ID: 0446536544 Enrollment ID: I20170403002293 |
| Provider Name | Aymen Bukannan |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1700179983 PECOS PAC ID: 3779700091 Enrollment ID: I20170918002329 |
| Provider Name | Mary Kathryn Hanisee |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1760771356 PECOS PAC ID: 9133420243 Enrollment ID: I20171030003287 |
| Provider Name | Jessica B Burns |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376080515 PECOS PAC ID: 1052662566 Enrollment ID: I20180922000206 |
| Provider Name | Jessica Lynn Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235615618 PECOS PAC ID: 8325390792 Enrollment ID: I20181012000774 |
| Provider Name | Anna A Gray |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083198584 PECOS PAC ID: 1850636341 Enrollment ID: I20190103001202 |
| Provider Name | Heather Melissa Wells |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821584459 PECOS PAC ID: 1951649680 Enrollment ID: I20190205001732 |
| Provider Name | Sarah N Sumner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205398914 PECOS PAC ID: 0244563476 Enrollment ID: I20190603002981 |
| Provider Name | Chisom Onuoha |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1447519376 PECOS PAC ID: 7719280924 Enrollment ID: I20190816003064 |
| Provider Name | Tiffany F Woolum |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558914911 PECOS PAC ID: 5395075410 Enrollment ID: I20191002002243 |
| Provider Name | Jessica T Brown |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356987457 PECOS PAC ID: 7214362987 Enrollment ID: I20200128000112 |
| Provider Name | Rachel Anderson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1407383805 PECOS PAC ID: 6800222944 Enrollment ID: I20200207001288 |
| Provider Name | Kaycie Langston |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457987349 PECOS PAC ID: 7719316926 Enrollment ID: I20200408003143 |
| Provider Name | Nadir Ismat Ishag Osman |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1942429485 PECOS PAC ID: 9335318047 Enrollment ID: I20200616001703 |
| Provider Name | Atul Kumar |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1316049257 PECOS PAC ID: 3072790831 Enrollment ID: I20200917001917 |
| Provider Name | Brittni Harrell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386124212 PECOS PAC ID: 1759626344 Enrollment ID: I20210608002531 |
| Provider Name | Eric Daniel Webb |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1912351255 PECOS PAC ID: 0547550451 Enrollment ID: I20210714003116 |
| Provider Name | Jeet Kapadia |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1942739099 PECOS PAC ID: 5597034090 Enrollment ID: I20210715001043 |
| Provider Name | Justin Fincher |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1053734517 PECOS PAC ID: 4284950718 Enrollment ID: I20210719001164 |
| Provider Name | Dhruv Chaudhary |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1679968200 PECOS PAC ID: 3375843832 Enrollment ID: I20210729001219 |
| Provider Name | Morgan Lane |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1467849026 PECOS PAC ID: 0244525418 Enrollment ID: I20210805002675 |
| Provider Name | Sherria M Norwood |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649844978 PECOS PAC ID: 3072874429 Enrollment ID: I20210825001759 |
| Provider Name | Shannon E Moninger |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790256667 PECOS PAC ID: 7517206824 Enrollment ID: I20220413000108 |
| Provider Name | Tamie Taylor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619612769 PECOS PAC ID: 5496132185 Enrollment ID: I20220518002527 |
| Provider Name | David Gutman |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1376507079 PECOS PAC ID: 8921012113 Enrollment ID: I20220701002309 |
| Provider Name | Stavros Stavropoulos |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1679657019 PECOS PAC ID: 5799740957 Enrollment ID: I20220902002893 |
| Provider Name | William Lee |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1982067484 PECOS PAC ID: 3375834609 Enrollment ID: I20220902002919 |
| Provider Name | Imtiaz Alam |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1619064284 PECOS PAC ID: 7416932371 Enrollment ID: I20221107002398 |
| Provider Name | Roslyn F Moore |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437875879 PECOS PAC ID: 4789051343 Enrollment ID: I20221110002380 |
| Provider Name | Ronald S Batin |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1114920733 PECOS PAC ID: 8921165705 Enrollment ID: I20221202001006 |
| Provider Name | Sara Melissa Lovette |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174249759 PECOS PAC ID: 0042682353 Enrollment ID: I20230215001248 |
| Provider Name | Samantha Dayawansa |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1376980649 PECOS PAC ID: 5890078950 Enrollment ID: I20230426000910 |
| Provider Name | Michael Ansstas |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1851658728 PECOS PAC ID: 5092084277 Enrollment ID: I20230628002123 |
| Provider Name | Christian J Trujillo |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1710408554 PECOS PAC ID: 5890069256 Enrollment ID: I20230829001318 |
| Provider Name | Donna M Mclean |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194700153 PECOS PAC ID: 2668401787 Enrollment ID: I20230911002652 |
| Provider Name | Brittney M Williams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689457806 PECOS PAC ID: 2668836123 Enrollment ID: I20230915003243 |
Shaw Living Pc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2484 E Pinetree Blvd, Thomasville, GA 31792 Phone: 229-226-8800 Fax: 229-226-8232 | |
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Rural Hiv Model Thomasville Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 14540 Us Hwy 19 S Ste#1, Thomasville, GA 31757 Phone: 229-225-3996 Fax: 229-436-4107 | |
Direct Patient Care Of Thomasville Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 701 S Hansell St, Thomasville, GA 31792 Phone: 229-233-6326 | |
Primary Care Of Southwest Georgia, Inc. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 454 Smith Ave, Thomasville, GA 31792 Phone: 229-227-5510 Fax: 229-227-5527 | |
Primary Care Of Southwest Georgia-tcms Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 4681 Us Highway 84 Byp W, Thomasville, GA 31792 Phone: 229-227-2936 Fax: 229-225-5284 |