| Shaw Living Pc | |
|
2484 E Pinetree Blvd Thomasville GA 31792-4854 | |
| (229) 226-8800 | |
| (229) 226-8232 |
| Full Name | Shaw Living Pc |
|---|---|
| Speciality | Family Medicine |
| Location | 2484 E Pinetree Blvd, Thomasville, Georgia |
| Authorized Official Name and Position | Lacy Bradford (OFFICE MANAGER) |
| Authorized Official Contact | 2295946800 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Shaw Living Pc 2484 E Pinetree Blvd Thomasville GA 31792-4854 Ph: (229) 594-6800 | Shaw Living Pc 2484 E Pinetree Blvd Thomasville GA 31792-4854 Ph: (229) 226-8800 |
| NPI Number | 1033778923 |
|---|---|
| Provider Enumeration Date | 06/13/2019 |
| Last Update Date | 02/28/2024 |
| Medicare PECOS PAC ID | 6800221904 |
|---|---|
| Medicare Enrollment ID | O20200118000078 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033778923 | NPI | - | NPPES |
| 179012663G | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Lisa S Carr |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073568630 PECOS PAC ID: 3476445800 Enrollment ID: I20040329001168 |
| Provider Name | Sabra E Lowe |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1770517336 PECOS PAC ID: 2668401118 Enrollment ID: I20050805000148 |
| Provider Name | Brandi W Warren |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1417046517 PECOS PAC ID: 2668472093 Enrollment ID: I20090107000004 |
| Provider Name | Elizabeth Alperin Nicholson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1245558964 PECOS PAC ID: 5799972741 Enrollment ID: I20110225000468 |
| Provider Name | Martha Hanna |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790178564 PECOS PAC ID: 3971823006 Enrollment ID: I20150513001480 |
| Provider Name | Brenda W. Mccurdy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083015531 PECOS PAC ID: 5496005597 Enrollment ID: I20180911003454 |
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