| Southland Behavioral Health Services Llc | |
|
2209 Pineview Dr Valdosta GA 31602-7316 | |
| (229) 236-0831 | |
| (229) 236-0871 |
| Full Name | Southland Behavioral Health Services Llc |
|---|---|
| Speciality | Hospitalist |
| Location | 2209 Pineview Dr, Valdosta, Georgia |
| Authorized Official Name and Position | Stephanie Fletcher (CFO) |
| Authorized Official Contact | 2292360831 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Southland Behavioral Health Services Llc Po Box 1276 Thomasville GA 31799-1276 Ph: (229) 236-0831 | Southland Behavioral Health Services Llc 2209 Pineview Dr Valdosta GA 31602-7316 Ph: (229) 236-0831 |
| NPI Number | 1619505765 |
|---|---|
| Provider Enumeration Date | 04/01/2020 |
| Last Update Date | 04/01/2020 |
| Medicare PECOS PAC ID | 8224469085 |
|---|---|
| Medicare Enrollment ID | O20200511002208 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619505765 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 208M00000X | Hospitalist | (* (Not Available)) | Primary |
| Provider Name | Daniel J Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265491294 PECOS PAC ID: 5092601682 Enrollment ID: I20040226000524 |
| Provider Name | Thomas W Hobby |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1497749733 PECOS PAC ID: 5092763318 Enrollment ID: I20050104000332 |
| Provider Name | Alford T Brady |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1467449272 PECOS PAC ID: 8628026960 Enrollment ID: I20050104000504 |
| Provider Name | Deborah Irene K Flack |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1265490999 PECOS PAC ID: 9335188598 Enrollment ID: I20050427000507 |
| Provider Name | Jonathan Steven Williams |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1346391299 PECOS PAC ID: 6507954799 Enrollment ID: I20071126000151 |
| Provider Name | Anita D Sinnott |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083835227 PECOS PAC ID: 4486743101 Enrollment ID: I20071204000228 |
| Provider Name | Mark Lee |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1619028255 PECOS PAC ID: 7113004524 Enrollment ID: I20080409000740 |
| Provider Name | Andrew D Magnet |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1063411601 PECOS PAC ID: 7911000518 Enrollment ID: I20080520000229 |
| Provider Name | Atul M Devani |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1053571117 PECOS PAC ID: 0446421341 Enrollment ID: I20110927000019 |
| Provider Name | Kristina N Johnson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1841426707 PECOS PAC ID: 5991951220 Enrollment ID: I20120801000963 |
| Provider Name | Elizabeth E. Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790125813 PECOS PAC ID: 7911135017 Enrollment ID: I20140117001123 |
| Provider Name | Vijia P George |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1386804441 PECOS PAC ID: 6204067929 Enrollment ID: I20140322000228 |
| Provider Name | Mesheal L Leverett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124420856 PECOS PAC ID: 6103149463 Enrollment ID: I20141218000820 |
| Provider Name | Jeremy Garrard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386871895 PECOS PAC ID: 2365674645 Enrollment ID: I20150817001118 |
| Provider Name | Keywanna Nichole Price |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588020234 PECOS PAC ID: 8123317252 Enrollment ID: I20160512002200 |
| Provider Name | Scott Thomas Miles |
|---|---|
| Provider Type | Practitioner - Addiction Medicine |
| Provider Identifiers | NPI Number: 1073512125 PECOS PAC ID: 9032164512 Enrollment ID: I20170206002875 |
| Provider Name | Catherine Richards |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942745575 PECOS PAC ID: 4486938552 Enrollment ID: I20170309001135 |
| Provider Name | Margaret C Carter-poore |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235652421 PECOS PAC ID: 6507139136 Enrollment ID: I20170901002753 |
| Provider Name | Tasha N Walker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750836805 PECOS PAC ID: 2163786708 Enrollment ID: I20180507000408 |
| Provider Name | Jenna H Poppell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164964243 PECOS PAC ID: 7315292067 Enrollment ID: I20180620001835 |
| Provider Name | Heather Whitney Mcmanis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811474828 PECOS PAC ID: 4183964216 Enrollment ID: I20190327000934 |
| Provider Name | Timothy Stinson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235791518 PECOS PAC ID: 9133026859 Enrollment ID: I20191206001343 |
| Provider Name | Rebecca Nicole Williford |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316585185 PECOS PAC ID: 1153740972 Enrollment ID: I20200929000825 |
| Provider Name | Shnita G Wiley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053914341 PECOS PAC ID: 7810399714 Enrollment ID: I20210715000645 |
| Provider Name | Jina Kiele Anderson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609525492 PECOS PAC ID: 9335536267 Enrollment ID: I20220425001023 |
Joseph S Thomas M D Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 410 Connell Rd, Ste T, Valdosta, GA 31602 Phone: 229-242-9565 Fax: 229-242-1725 | |
Care Medical Center Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2804 N Oak St, Suite C, Valdosta, GA 31602 Phone: 229-241-8925 Fax: 229-241-7672 | |
Griner Medical Group Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 3301 N Oak Street Ext, Valdosta, GA 31605 Phone: 229-242-6061 Fax: 229-242-6151 | |
Valdosta Medical Associates Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3300 Greystone Way, Valdosta, GA 31605 Phone: 229-247-7700 | |
Valdosta Gastroenterology Associates, Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 410 Connell Rd, Valdosta, GA 31602 Phone: 229-244-1570 Fax: 229-247-1084 | |
Partnership Health Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 520 Griffin Ave, Valdosta, GA 31601 Phone: 229-245-0020 Fax: 229-245-9855 | |
Bennett P Hogan Md Pc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 117 W Northside Dr, Valdosta, GA 31602 Phone: 229-333-0616 Fax: 229-333-0647 |