| Medlink Georgia Inc | |
|
11 Charlie Morris Rd Colbert GA 30628-2445 | |
| (706) 788-3234 | |
| Not Available |
| Full Name | Medlink Georgia Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 11 Charlie Morris Rd, Colbert, Georgia |
| Authorized Official Name and Position | David Ward (CEO) |
| Authorized Official Contact | 7067883234 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Medlink Georgia Inc Po Box 459 Colbert GA 30628-0459 Ph: (706) 788-3234 | Medlink Georgia Inc 11 Charlie Morris Rd Colbert GA 30628-2445 Ph: (706) 788-3234 |
| NPI Number | 1396794541 |
|---|---|
| Provider Enumeration Date | 05/08/2006 |
| Last Update Date | 05/03/2022 |
| Medicare PECOS PAC ID | 3274442850 |
|---|---|
| Medicare Enrollment ID | O20040303000376 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396794541 | NPI | - | NPPES |
| GPA868 | Medicaid | SC | |
| 89014RK | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
| Provider Name | Lonnie Keith Sipsy |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1518925767 PECOS PAC ID: 8628033032 Enrollment ID: I20041124000833 |
| Provider Name | Theodore K Schock |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1023179090 PECOS PAC ID: 6002879327 Enrollment ID: I20050301000564 |
| Provider Name | Shannon L Robinson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679536429 PECOS PAC ID: 6709817596 Enrollment ID: I20050822000696 |
| Provider Name | Jason B Hurt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356325112 PECOS PAC ID: 4183657307 Enrollment ID: I20050916000692 |
| Provider Name | Nancy Mccoy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841390226 PECOS PAC ID: 6507880846 Enrollment ID: I20060125000511 |
| Provider Name | Maria Isabel Alban |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1396857587 PECOS PAC ID: 8426095191 Enrollment ID: I20060126000023 |
| Provider Name | Anthony R Gordon |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1386602464 PECOS PAC ID: 2365440575 Enrollment ID: I20061127000108 |
| Provider Name | Samuel K Sencil |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1699816322 PECOS PAC ID: 9133135478 Enrollment ID: I20071017000704 |
| Provider Name | Kathryn Mccusker |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1992926083 PECOS PAC ID: 6901976257 Enrollment ID: I20080529000652 |
| Provider Name | Syed Sami Hyder Zaidi |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1649470626 PECOS PAC ID: 2668560327 Enrollment ID: I20080603000759 |
| Provider Name | Rodney A Raker |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1770542417 PECOS PAC ID: 7113098179 Enrollment ID: I20080618000557 |
| Provider Name | Lee Lindsey Bleshoy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669636767 PECOS PAC ID: 3476627779 Enrollment ID: I20080805000379 |
| Provider Name | Sandra T Seaton |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1770622565 PECOS PAC ID: 4486792835 Enrollment ID: I20091105000327 |
| Provider Name | Joan T James |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1801041595 PECOS PAC ID: 1052592011 Enrollment ID: I20110223000922 |
| Provider Name | Paula S Price |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881847176 PECOS PAC ID: 0446420962 Enrollment ID: I20110818000867 |
| Provider Name | Haroon Mian |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1326210899 PECOS PAC ID: 9830385244 Enrollment ID: I20111109000639 |
| Provider Name | Susan L Hawn |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1225093214 PECOS PAC ID: 8820262959 Enrollment ID: I20111129000372 |
| Provider Name | Kimberly Martin |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1073564480 PECOS PAC ID: 5698736577 Enrollment ID: I20130226000406 |
| Provider Name | Meredith C Udell |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1871768002 PECOS PAC ID: 1254502297 Enrollment ID: I20130311000353 |
| Provider Name | Karen J Frank |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1447201876 PECOS PAC ID: 3870554751 Enrollment ID: I20130314000168 |
| Provider Name | Ling Li |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1255652053 PECOS PAC ID: 6507017035 Enrollment ID: I20130924000367 |
| Provider Name | Denise Hanak Atkins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497136576 PECOS PAC ID: 2961719042 Enrollment ID: I20150922002580 |
| Provider Name | Candace Vandiver |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720451222 PECOS PAC ID: 7618277559 Enrollment ID: I20151130000355 |
| Provider Name | Jeffrey D Trawick |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1982043709 PECOS PAC ID: 1254644842 Enrollment ID: I20160810002336 |
| Provider Name | Mushtaq Ahmed |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1457592552 PECOS PAC ID: 6002100039 Enrollment ID: I20160812001816 |
| Provider Name | Nirdesh Sharma |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1942432364 PECOS PAC ID: 6305131277 Enrollment ID: I20160817002010 |
| Provider Name | Flor Estella Quijada |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477008902 PECOS PAC ID: 2062709066 Enrollment ID: I20160919002069 |
| Provider Name | Daniel Gordon |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1467862813 PECOS PAC ID: 6204139595 Enrollment ID: I20161019002553 |
| Provider Name | Jordan Hoffman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1801248182 PECOS PAC ID: 1456636331 Enrollment ID: I20170315001419 |
| Provider Name | Jeralyn Smith |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1437130135 PECOS PAC ID: 6305115031 Enrollment ID: I20170711003626 |
| Provider Name | Nora Blankenship |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1336492503 PECOS PAC ID: 1658647847 Enrollment ID: I20171016001008 |
| Provider Name | Diane Allison |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1992816243 PECOS PAC ID: 8820364664 Enrollment ID: I20171024001459 |
| Provider Name | Loretta Duggan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1376809665 PECOS PAC ID: 5496993008 Enrollment ID: I20171205003594 |
| Provider Name | Amanda H Pileski |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1215206040 PECOS PAC ID: 1254696156 Enrollment ID: I20180614003101 |
| Provider Name | Heather Hill |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336649128 PECOS PAC ID: 4688920564 Enrollment ID: I20180706002103 |
| Provider Name | Anny Sosebee |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164916581 PECOS PAC ID: 1951650761 Enrollment ID: I20180827003031 |
| Provider Name | Kelly Montgomery |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1851680938 PECOS PAC ID: 6507135340 Enrollment ID: I20181105000295 |
| Provider Name | Rebecca Redding |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1144601121 PECOS PAC ID: 1254649288 Enrollment ID: I20181116002247 |
| Provider Name | Derek Arthur Klemm |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1225300494 PECOS PAC ID: 8729332242 Enrollment ID: I20181119002180 |
| Provider Name | Rebekah Hawkins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942779772 PECOS PAC ID: 2466791538 Enrollment ID: I20190307000947 |
| Provider Name | Akilah Tomingas |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1972897700 PECOS PAC ID: 9133340177 Enrollment ID: I20190313003028 |
| Provider Name | Amy Davidson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295273571 PECOS PAC ID: 0749521391 Enrollment ID: I20190408001998 |
| Provider Name | Tiffany Payne |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730645219 PECOS PAC ID: 6204178965 Enrollment ID: I20190429001401 |
| Provider Name | Evan Grovenstein |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174184030 PECOS PAC ID: 8325375033 Enrollment ID: I20190802002080 |
| Provider Name | Savannah L Smith |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1093102675 PECOS PAC ID: 0345578746 Enrollment ID: I20190822003782 |
| Provider Name | Rachel Bright |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558838326 PECOS PAC ID: 7618206798 Enrollment ID: I20190916001720 |
| Provider Name | Philip Young Kong |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205489929 PECOS PAC ID: 9739419094 Enrollment ID: I20190930001192 |
| Provider Name | Melissa Pruitt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295392975 PECOS PAC ID: 2860723020 Enrollment ID: I20191018002751 |
| Provider Name | Heather Lynn Higgins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730736570 PECOS PAC ID: 7416288675 Enrollment ID: I20191021000089 |
| Provider Name | Jennifer Ruth Madore |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1528615713 PECOS PAC ID: 3870926538 Enrollment ID: I20191210003595 |
| Provider Name | Gina Marie Looney |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548714512 PECOS PAC ID: 0648565374 Enrollment ID: I20191212002875 |
| Provider Name | Tina Lynn Shehee |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710542287 PECOS PAC ID: 8325476989 Enrollment ID: I20200312001488 |
| Provider Name | Stephen Aaron Purser |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1083148423 PECOS PAC ID: 3870846710 Enrollment ID: I20200723003159 |
| Provider Name | Sarah Parker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063863645 PECOS PAC ID: 6204251705 Enrollment ID: I20200730003383 |
| Provider Name | Nicole Powell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902423841 PECOS PAC ID: 9436574266 Enrollment ID: I20200810003416 |
| Provider Name | Kristen Maxwell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396353355 PECOS PAC ID: 6204253057 Enrollment ID: I20200825003657 |
| Provider Name | Julie Farrow |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1447243142 PECOS PAC ID: 2365513926 Enrollment ID: I20201020000967 |
| Provider Name | Evelyn Aviles |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194334409 PECOS PAC ID: 3678983962 Enrollment ID: I20201027001649 |
| Provider Name | Michael Timmel |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1760472096 PECOS PAC ID: 8921089889 Enrollment ID: I20201119000281 |
| Provider Name | Ernie Aldaco |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689009953 PECOS PAC ID: 5890101166 Enrollment ID: I20210311000274 |
| Provider Name | Clayton Reid |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285215319 PECOS PAC ID: 9830598192 Enrollment ID: I20210519001148 |
| Provider Name | Deanna Essig |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568036002 PECOS PAC ID: 8224438999 Enrollment ID: I20210617000733 |
| Provider Name | Josie Eavenson Freeman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730758418 PECOS PAC ID: 0547662157 Enrollment ID: I20210706000374 |
| Provider Name | Jane Marie Purser |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215509013 PECOS PAC ID: 3476955188 Enrollment ID: I20210716001296 |
| Provider Name | Jorie Muraida |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1780176305 PECOS PAC ID: 9931501699 Enrollment ID: I20210716002798 |
| Provider Name | David Moise |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1245734367 PECOS PAC ID: 1850794116 Enrollment ID: I20210723001199 |
| Provider Name | Jennifer E Wiley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821660978 PECOS PAC ID: 2163325127 Enrollment ID: I20210803000244 |
| Provider Name | Tamara Starling Herman |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1821614926 PECOS PAC ID: 3173921475 Enrollment ID: I20211020000679 |
| Provider Name | Donald E Nichols |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1871560235 PECOS PAC ID: 6901708908 Enrollment ID: I20220429001852 |
| Provider Name | Jennifer Meeks |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497486047 PECOS PAC ID: 0648650176 Enrollment ID: I20220630001012 |
| Provider Name | Heather Michele Jones |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053954768 PECOS PAC ID: 9638559446 Enrollment ID: I20220711000179 |
| Provider Name | Brenna Clinansmith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336887595 PECOS PAC ID: 1658751490 Enrollment ID: I20220711000927 |
| Provider Name | Cameron Dean Wagenbrenner |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1063995561 PECOS PAC ID: 2264814573 Enrollment ID: I20220803002354 |
| Provider Name | Monick Crain |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639802473 PECOS PAC ID: 9739563420 Enrollment ID: I20220830000452 |
| Provider Name | Rachel Anne Rainey |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1386266468 PECOS PAC ID: 9638545148 Enrollment ID: I20221024002394 |
| Provider Name | Linda Tejada Mahomar |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730896572 PECOS PAC ID: 7517335938 Enrollment ID: I20221116000992 |
| Provider Name | Trenice Morton |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1447831250 PECOS PAC ID: 1052783669 Enrollment ID: I20230208001309 |
| Provider Name | Reno James Roberts |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1669094959 PECOS PAC ID: 6800269853 Enrollment ID: I20230222002509 |
| Provider Name | Gisele Youth |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1710447537 PECOS PAC ID: 0749655090 Enrollment ID: I20230419000240 |
| Provider Name | Melonie Grace Singleton |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1679124390 PECOS PAC ID: 7315307584 Enrollment ID: I20230719002781 |
| Provider Name | Mysonya Earlisa Martin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891474300 PECOS PAC ID: 0749640779 Enrollment ID: I20230721001419 |
| Provider Name | Justin Souter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205539293 PECOS PAC ID: 2961863584 Enrollment ID: I20230731000551 |
| Provider Name | Selina Farley Sanders |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649055534 PECOS PAC ID: 1759745607 Enrollment ID: I20230912001451 |
| Provider Name | Elizabeth J Pelaccio |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1386327245 PECOS PAC ID: 7517314636 Enrollment ID: I20231111000423 |
| Provider Name | Ann Whitaker |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1699158584 PECOS PAC ID: 1658728605 Enrollment ID: I20231113001943 |
| Provider Name | Natalie Elizabeth Kelly |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1417139601 PECOS PAC ID: 2668555814 Enrollment ID: I20240212000842 |
| Provider Name | Keo L Copeland |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1225813025 PECOS PAC ID: 1254778228 Enrollment ID: I20240326002741 |
| Provider Name | Allison Dooley |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1639398290 PECOS PAC ID: 5799879722 Enrollment ID: I20240419001107 |
Medlink Colbert Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 11 Charlie Morris Rd, Colbert, GA 30628 Phone: 706-788-2127 | |
Medlink Colbert Building 2 Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 11 Charlie Morris Rd Bldg 2, Colbert, GA 30628 Phone: 706-788-2127 |