Primary Care Of Southwest Georgia, Inc. | |
454 Smith Ave Thomasville GA 31792-5535 | |
(229) 227-5510 | |
(229) 227-5527 |
Full Name | Primary Care Of Southwest Georgia, Inc. |
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Speciality | Clinic/Center |
Location | 454 Smith Ave, Thomasville, Georgia |
Authorized Official Name and Position | Angela Mcvey (CEO) |
Authorized Official Contact | 2297232660 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Primary Care Of Southwest Georgia, Inc. Po Box 1479 Thomasville GA 31799-1479 Ph: (229) 227-5510 | Primary Care Of Southwest Georgia, Inc. 454 Smith Ave Thomasville GA 31792-5535 Ph: (229) 227-5510 |
NPI Number | 1366641318 |
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Provider Enumeration Date | 07/11/2007 |
Last Update Date | 03/03/2022 |
Medicare PECOS PAC ID | 5496777948 |
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Medicare Enrollment ID | O20060201000362 |
Identifier | Type | State | Issuer |
---|---|---|---|
1366641318 | NPI | - | NPPES |
024893266C | Medicaid | GA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Provider Name | James T Brown |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1326082298 PECOS PAC ID: 3577459254 Enrollment ID: I20040227000713 |
Provider Name | Murdoc M Henderson |
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Provider Type | Practitioner - Obstetrics/gynecology |
Provider Identifiers | NPI Number: 1245299387 PECOS PAC ID: 7517936123 Enrollment ID: I20040930000316 |
Provider Name | Wayne H Friedman |
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Provider Type | Practitioner - Obstetrics/gynecology |
Provider Identifiers | NPI Number: 1730247412 PECOS PAC ID: 3577596865 Enrollment ID: I20050916000396 |
Provider Name | Barbara H Mccollum |
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Provider Type | Practitioner - Obstetrics/gynecology |
Provider Identifiers | NPI Number: 1083636351 PECOS PAC ID: 5395748917 Enrollment ID: I20060821000044 |
Provider Name | Michael Scott Schmidt |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1669572970 PECOS PAC ID: 4880676634 Enrollment ID: I20061109000445 |
Provider Name | Maria Mock |
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Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
Provider Identifiers | NPI Number: 1285818757 PECOS PAC ID: 8224114384 Enrollment ID: I20080329000013 |
Provider Name | Jason B Moye |
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Provider Type | Practitioner - Obstetrics/gynecology |
Provider Identifiers | NPI Number: 1629255252 PECOS PAC ID: 5597896522 Enrollment ID: I20100708000274 |
Provider Name | Robinson H Stubley |
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Provider Type | Practitioner - Obstetrics/gynecology |
Provider Identifiers | NPI Number: 1962457879 PECOS PAC ID: 5991843146 Enrollment ID: I20101004000165 |
Provider Name | Melissa S Bruhn |
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Provider Type | Practitioner - Obstetrics/gynecology |
Provider Identifiers | NPI Number: 1598710402 PECOS PAC ID: 5395882021 Enrollment ID: I20101008000296 |
Provider Name | Joseph Stephen Novak |
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Provider Type | Practitioner - Obstetrics/gynecology |
Provider Identifiers | NPI Number: 1245218361 PECOS PAC ID: 1951595842 Enrollment ID: I20101104000955 |
Provider Name | Bridget A Barrow |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1588949432 PECOS PAC ID: 7517130123 Enrollment ID: I20111026000876 |
Provider Name | Raina C Ferenchick |
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Provider Type | Practitioner - Obstetrics/gynecology |
Provider Identifiers | NPI Number: 1306146451 PECOS PAC ID: 9032359104 Enrollment ID: I20130712000642 |
Provider Name | Geri E Justice |
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Provider Type | Practitioner - Obstetrics/gynecology |
Provider Identifiers | NPI Number: 1295963759 PECOS PAC ID: 0648414821 Enrollment ID: I20130910000920 |
Provider Name | Elizabeth S Mansfield |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1639582281 PECOS PAC ID: 6709006422 Enrollment ID: I20141001001241 |
Provider Name | Melisa Moore |
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Provider Type | Practitioner - Psychologist Billing Independently |
Provider Identifiers | NPI Number: 1942582820 PECOS PAC ID: 0941527642 Enrollment ID: I20150317002083 |
Provider Name | Aretha Tinson |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1235460833 PECOS PAC ID: 7810919370 Enrollment ID: I20150413001821 |
Provider Name | Whitney Vance |
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Provider Type | Practitioner - Obstetrics/gynecology |
Provider Identifiers | NPI Number: 1528328481 PECOS PAC ID: 3173789716 Enrollment ID: I20160901001826 |
Provider Name | Rachael C Lackey |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1780922849 PECOS PAC ID: 6901197904 Enrollment ID: I20161018000077 |
Provider Name | Murali Mohan Yelugapuri |
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Provider Type | Practitioner - Pediatric Medicine |
Provider Identifiers | NPI Number: 1518156033 PECOS PAC ID: 8820377468 Enrollment ID: I20161122001318 |
Provider Name | Craig J Lenz |
---|---|
Provider Type | Practitioner - Obstetrics/gynecology |
Provider Identifiers | NPI Number: 1225476393 PECOS PAC ID: 2062716582 Enrollment ID: I20171114002327 |
Provider Name | Kristen Mary Murphy |
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Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
Provider Identifiers | NPI Number: 1992207047 PECOS PAC ID: 3971854068 Enrollment ID: I20180928002757 |
Provider Name | Lisa J Sellers |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1275012015 PECOS PAC ID: 4082954557 Enrollment ID: I20190319003004 |
Provider Name | Emily Conoly |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1518422450 PECOS PAC ID: 1557603495 Enrollment ID: I20190425001234 |
Provider Name | Dave O Stewart |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1588014807 PECOS PAC ID: 3476849811 Enrollment ID: I20190913002319 |
Provider Name | Briana Manley Hall |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1780168203 PECOS PAC ID: 6002244498 Enrollment ID: I20200318001160 |
Provider Name | Brittany Reichert |
---|---|
Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1497388896 PECOS PAC ID: 6901234194 Enrollment ID: I20200323001226 |
Provider Name | De'smond M Henry |
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Provider Type | Practitioner - Obstetrics/gynecology |
Provider Identifiers | NPI Number: 1528492923 PECOS PAC ID: 5890097976 Enrollment ID: I20201123000719 |
Provider Name | Daneisha Hill-patterson |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1821689720 PECOS PAC ID: 9133529191 Enrollment ID: I20210611002185 |
Provider Name | Melanie Hattink |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1710594106 PECOS PAC ID: 6901296458 Enrollment ID: I20211124001172 |
Provider Name | Gabrielle Gardner Norris |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1619529344 PECOS PAC ID: 2264761923 Enrollment ID: I20220502000238 |
Provider Name | Melody Elise Price |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1083716427 PECOS PAC ID: 3476932468 Enrollment ID: I20220622001219 |
Provider Name | Kimberely Dawn Johnson |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1215416516 PECOS PAC ID: 0143605113 Enrollment ID: I20220913000667 |
Provider Name | Ramsey B Hughes |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1043915168 PECOS PAC ID: 1759746761 Enrollment ID: I20230426002348 |
Provider Name | Raquel Adams |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1649948092 PECOS PAC ID: 2860857554 Enrollment ID: I20230502002802 |
Provider Name | Mary Racheal Havens |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1023780400 PECOS PAC ID: 5092103952 Enrollment ID: I20230503003505 |
Provider Name | Nina Carter |
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Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1851878755 PECOS PAC ID: 1850744848 Enrollment ID: I20240125003423 |
Provider Name | Haley Dowling Rykard |
---|---|
Provider Type | Practitioner - Marriage And Family Therapist |
Provider Identifiers | NPI Number: 1821624040 PECOS PAC ID: 9133562317 Enrollment ID: I20240205001498 |
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