| Wayne Sjc Medical Group, Llc | |
|
320 Peachtree St Jesup GA 31545-0244 | |
| (912) 427-7790 | |
| (912) 427-7707 |
| Full Name | Wayne Sjc Medical Group, Llc |
|---|---|
| Speciality | Otolaryngology |
| Location | 320 Peachtree St, Jesup, Georgia |
| Authorized Official Name and Position | Joseph P Ierardi (CEO) |
| Authorized Official Contact | 9124277790 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Wayne Sjc Medical Group, Llc 320 Peachtree St Jesup GA 31545-0244 Ph: (912) 427-7790 | Wayne Sjc Medical Group, Llc 320 Peachtree St Jesup GA 31545-0244 Ph: (912) 427-7790 |
| NPI Number | 1538421177 |
|---|---|
| Provider Enumeration Date | 06/11/2012 |
| Last Update Date | 08/25/2016 |
| Medicare PECOS PAC ID | 5496901811 |
|---|---|
| Medicare Enrollment ID | O20120817000029 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538421177 | NPI | - | NPPES |
| 272895969C | Medicaid | GA | |
| 003127436A | Medicaid | GA |
| Provider Name | Regina L Andrews |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881874782 PECOS PAC ID: 7911080965 Enrollment ID: I20080213000625 |
| Provider Name | Patrice Moore |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1447394697 PECOS PAC ID: 9537348073 Enrollment ID: I20111222000481 |
| Provider Name | Ogochukwu Chizoba Adaku Okpala |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1407925324 PECOS PAC ID: 6800977828 Enrollment ID: I20140331000746 |
| Provider Name | Gary R Stern |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1700812633 PECOS PAC ID: 4789603176 Enrollment ID: I20141015002145 |
| Provider Name | Dorothy Karen Nelder |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1285695338 PECOS PAC ID: 2860499829 Enrollment ID: I20181003002097 |
| Provider Name | Steven Austin Roth |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1942386727 PECOS PAC ID: 6103850540 Enrollment ID: I20210120002029 |
| Provider Name | Stephanie Lyne Chadwick |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376135798 PECOS PAC ID: 0345657300 Enrollment ID: I20210323001515 |
| Provider Name | Beth A Lewis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205457264 PECOS PAC ID: 4385044072 Enrollment ID: I20210617001206 |
Lentz Urgent Care & Family Med, Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 182 Sunset Blvd, Jesup, GA 31545 Phone: 912-385-2102 Fax: 912-385-2180 | |
Headley Family Medicine, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 825 S 1st St, Jesup, GA 31545 Phone: 912-427-7400 Fax: 912-385-2953 | |
Wayne Family Practice Associates, P.c. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 330 Peachtree St, Jesup, GA 31545 Phone: 912-427-6964 Fax: 912-427-0591 | |
Golden Isles Family Practice Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1249 S 1st St, Jesup, GA 31545 Phone: 912-427-8031 Fax: 912-427-8032 | |
Internal Medicine Of Southeast Georgia Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 351 Peachtree St, Jesup, GA 31545 Phone: 912-530-6582 Fax: 912-530-6584 | |
Peach Family Healthcare Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 142 S Brunswick St, Jesup, GA 31546 Phone: 912-385-2755 Fax: 912-385-2785 | |
Winnie Claire Hicks Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 162 Memorial Dr, Jesup, GA 31545 Phone: 912-588-2511 Fax: 912-588-2518 |