| Crisp Regional Hospital Inc | |
|
902 7th St North Cordele GA 31010 | |
| (229) 271-9686 | |
| (229) 271-9689 |
| Full Name | Crisp Regional Hospital Inc |
|---|---|
| Speciality | General Acute Care Hospital |
| Location | 902 7th St North, Cordele, Georgia |
| Authorized Official Name and Position | Lynn Renee Bearden (DIR REV INT) |
| Authorized Official Contact | 2292763146 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Crisp Regional Hospital Inc Po Box 5007 Cordele GA 31015-5007 Ph: (229) 271-9686 | Crisp Regional Hospital Inc 902 7th St North Cordele GA 31010 Ph: (229) 271-9686 |
| NPI Number | 1700851649 |
|---|---|
| Provider Enumeration Date | 02/22/2006 |
| Last Update Date | 12/08/2025 |
| Medicare PECOS PAC ID | 5991616336 |
|---|---|
| Medicare Enrollment ID | O20040107000032 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700851649 | NPI | - | NPPES |
| 000000514A | Medicaid | GA |
| Provider Name | Kenneth J Benjamin |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1245344928 PECOS PAC ID: 7315841210 Enrollment ID: I20031121000774 |
| Provider Name | Susan R Ethridge |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316922206 PECOS PAC ID: 2769371079 Enrollment ID: I20040315000119 |
| Provider Name | Ronald E Huet |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1306873427 PECOS PAC ID: 9234106253 Enrollment ID: I20040910000396 |
| Provider Name | Lansing C Hillman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1558351809 PECOS PAC ID: 7810958303 Enrollment ID: I20041020000770 |
| Provider Name | Charles E Bryan |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1649282575 PECOS PAC ID: 2264496363 Enrollment ID: I20041118000247 |
| Provider Name | Marion O Lee |
|---|---|
| Provider Type | Practitioner - Pain Management |
| Provider Identifiers | NPI Number: 1538110200 PECOS PAC ID: 6800851718 Enrollment ID: I20041119000598 |
| Provider Name | Sheila Southerland |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1528035326 PECOS PAC ID: 4688566987 Enrollment ID: I20050622000355 |
| Provider Name | Sandra J Carmichael |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1770514259 PECOS PAC ID: 8224066212 Enrollment ID: I20050801000498 |
| Provider Name | Cherinor Sillah |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1912931163 PECOS PAC ID: 7012910029 Enrollment ID: I20060811000397 |
| Provider Name | Mutinhima Moyo |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1497763015 PECOS PAC ID: 4486658119 Enrollment ID: I20060911000536 |
| Provider Name | Michael C Thompson |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1184732521 PECOS PAC ID: 1759387137 Enrollment ID: I20061006000375 |
| Provider Name | Craig Smith |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1194754697 PECOS PAC ID: 8123026069 Enrollment ID: I20061201000189 |
| Provider Name | Robert A Bartosh |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1487757928 PECOS PAC ID: 8325145766 Enrollment ID: I20070521000257 |
| Provider Name | Jonathan Williams |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1346391299 PECOS PAC ID: 6507954799 Enrollment ID: I20071126000151 |
| Provider Name | Vincent S Culpepper |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1023081437 PECOS PAC ID: 9638252497 Enrollment ID: I20080218000014 |
| Provider Name | Kristin S Rischar |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1184696817 PECOS PAC ID: 7113098575 Enrollment ID: I20080612000735 |
| Provider Name | Kevin M Holloway |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1114107810 PECOS PAC ID: 2860563962 Enrollment ID: I20080617000741 |
| Provider Name | Guy Young |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1124238878 PECOS PAC ID: 3274605647 Enrollment ID: I20080630000206 |
| Provider Name | Ernest M Jones |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1710950670 PECOS PAC ID: 2860564028 Enrollment ID: I20080702000620 |
| Provider Name | Rhonda G Bailey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639334709 PECOS PAC ID: 8022184019 Enrollment ID: I20080827000211 |
| Provider Name | Vithal Kusuma |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1750375051 PECOS PAC ID: 9436053774 Enrollment ID: I20090122000674 |
| Provider Name | David Kavtaradze |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1376516484 PECOS PAC ID: 7911052360 Enrollment ID: I20090908000537 |
| Provider Name | Bradley J Battaglia |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1619125754 PECOS PAC ID: 7315085909 Enrollment ID: I20091119000438 |
| Provider Name | Candace E Usry |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013149574 PECOS PAC ID: 6709925530 Enrollment ID: I20091208000072 |
| Provider Name | Thomas M Darden |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1992779946 PECOS PAC ID: 8729120027 Enrollment ID: I20100216000011 |
| Provider Name | Paul A Michas |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1750355574 PECOS PAC ID: 9638211931 Enrollment ID: I20100216000015 |
| Provider Name | Joel Bruce Zivot |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1639147077 PECOS PAC ID: 3971550161 Enrollment ID: I20100524000294 |
| Provider Name | Michael J Sterling |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1487633905 PECOS PAC ID: 0345285342 Enrollment ID: I20101015000576 |
| Provider Name | Thomas Fortson Neal |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1336247212 PECOS PAC ID: 8729272356 Enrollment ID: I20101028000001 |
| Provider Name | Geraldine Jones |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770899262 PECOS PAC ID: 4789870627 Enrollment ID: I20101118000320 |
| Provider Name | Priya Dharshini Ravindran |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1033167333 PECOS PAC ID: 1355371808 Enrollment ID: I20101229000440 |
| Provider Name | James W. Fordyce |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1114915618 PECOS PAC ID: 2769473834 Enrollment ID: I20110209000755 |
| Provider Name | Srilatha Nadipineni |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1073720496 PECOS PAC ID: 9931388386 Enrollment ID: I20110525000583 |
| Provider Name | Samantha D Manderson |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1588952063 PECOS PAC ID: 5698943173 Enrollment ID: I20110728000143 |
| Provider Name | James Benjamin Thomas |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1477596419 PECOS PAC ID: 1850387440 Enrollment ID: I20110801000580 |
| Provider Name | Deepak Reddy |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1518087568 PECOS PAC ID: 0840356028 Enrollment ID: I20110825000354 |
| Provider Name | Traci K Yawn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053690636 PECOS PAC ID: 2668643669 Enrollment ID: I20110923000252 |
| Provider Name | Beatrice H Mckee |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508141482 PECOS PAC ID: 2769655091 Enrollment ID: I20111102000661 |
| Provider Name | Ronald L Bridges |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1992037741 PECOS PAC ID: 4082746771 Enrollment ID: I20120613000053 |
| Provider Name | Lynn A Lyons |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1174681142 PECOS PAC ID: 8325220817 Enrollment ID: I20120711000513 |
| Provider Name | Henry N Burkes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912256140 PECOS PAC ID: 6103075163 Enrollment ID: I20121005000706 |
| Provider Name | Samyukta Chava |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1467622779 PECOS PAC ID: 4082784988 Enrollment ID: I20130102000339 |
| Provider Name | Joni Heather Duff |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1861730673 PECOS PAC ID: 5092951277 Enrollment ID: I20130412000214 |
| Provider Name | David J Cox |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1417102393 PECOS PAC ID: 3072665371 Enrollment ID: I20130723000647 |
| Provider Name | Avinesh Singh Bhar Jaswindar Singh |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1760634505 PECOS PAC ID: 0244472223 Enrollment ID: I20130805000654 |
| Provider Name | Claudia Conde |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1811204746 PECOS PAC ID: 1658514401 Enrollment ID: I20130827000746 |
| Provider Name | Jamie M Atkins |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1265424998 PECOS PAC ID: 2961645361 Enrollment ID: I20130904000748 |
| Provider Name | Carmen C Polito |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1558531285 PECOS PAC ID: 9638313893 Enrollment ID: I20130910000654 |
| Provider Name | David C Hardy |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1487997086 PECOS PAC ID: 2668609702 Enrollment ID: I20131216001331 |
| Provider Name | Kamardeen Diekola Alabi |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1649686825 PECOS PAC ID: 0547481400 Enrollment ID: I20141020000734 |
| Provider Name | Barry O Iguobadia |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1750671004 PECOS PAC ID: 2769603539 Enrollment ID: I20141020001401 |
| Provider Name | Juan Carlos Buitrago |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1346477288 PECOS PAC ID: 0042533382 Enrollment ID: I20141217002789 |
| Provider Name | Marcy A Christmas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023081031 PECOS PAC ID: 6406098334 Enrollment ID: I20150402001904 |
| Provider Name | Israel Saucedo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003222191 PECOS PAC ID: 7719205541 Enrollment ID: I20150407002204 |
| Provider Name | Phylis J Willis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497138911 PECOS PAC ID: 6507171428 Enrollment ID: I20150820010996 |
| Provider Name | Colin Swenson |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1902127723 PECOS PAC ID: 4486897816 Enrollment ID: I20150827001187 |
| Provider Name | Gaurav Budhrani |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1053635581 PECOS PAC ID: 0840516225 Enrollment ID: I20151001002377 |
| Provider Name | Oscar S Teal |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144698887 PECOS PAC ID: 3072822915 Enrollment ID: I20151016000241 |
| Provider Name | Lori Cobb Hobbs |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679027478 PECOS PAC ID: 7618262809 Enrollment ID: I20160826002050 |
| Provider Name | Bradley T Davis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083168793 PECOS PAC ID: 1153617493 Enrollment ID: I20160913000229 |
| Provider Name | Jack Bradley Royal |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1134483878 PECOS PAC ID: 5597993691 Enrollment ID: I20161031000047 |
| Provider Name | Tara L Hamilton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003346909 PECOS PAC ID: 6103197900 Enrollment ID: I20170811001117 |
| Provider Name | Haley Strange Revell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821537606 PECOS PAC ID: 1951674803 Enrollment ID: I20170829001727 |
| Provider Name | Samantha Strickler |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1437383916 PECOS PAC ID: 8022252659 Enrollment ID: I20171010001813 |
| Provider Name | Amit Prabhakar |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1790050037 PECOS PAC ID: 7618101247 Enrollment ID: I20171025000514 |
| Provider Name | Susan Mccard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063934388 PECOS PAC ID: 9032475322 Enrollment ID: I20171101002717 |
| Provider Name | Tammy Jolly |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508311283 PECOS PAC ID: 0547527293 Enrollment ID: I20171205001319 |
| Provider Name | Wendy Ann Neveu |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1851683072 PECOS PAC ID: 1052613353 Enrollment ID: I20180131001045 |
| Provider Name | Alicia Hair |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629596424 PECOS PAC ID: 9638428386 Enrollment ID: I20180814002459 |
| Provider Name | Kristina Abt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962993519 PECOS PAC ID: 8123372315 Enrollment ID: I20181106001749 |
| Provider Name | Matthew Scott Reaven |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1871989731 PECOS PAC ID: 6901173319 Enrollment ID: I20181211002817 |
| Provider Name | Teresa Tripp Ford |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023580420 PECOS PAC ID: 7810235710 Enrollment ID: I20190220000432 |
| Provider Name | Heather Nicole Self |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336611714 PECOS PAC ID: 2163763756 Enrollment ID: I20190409000626 |
| Provider Name | Brett E Mason |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1972098770 PECOS PAC ID: 4688917891 Enrollment ID: I20190509002162 |
| Provider Name | Brandi Newman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023576170 PECOS PAC ID: 9234472671 Enrollment ID: I20190528001579 |
| Provider Name | Abesh Niroula |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1871856468 PECOS PAC ID: 1254588916 Enrollment ID: I20190725000151 |
| Provider Name | Mathew Kadalikattil Thomas |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1023255858 PECOS PAC ID: 5698816387 Enrollment ID: I20190729000801 |
| Provider Name | Avanthika Thanushi Wynn |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1124306006 PECOS PAC ID: 7315162161 Enrollment ID: I20190731000224 |
| Provider Name | Allison C. Brock |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558920520 PECOS PAC ID: 3577891530 Enrollment ID: I20190828004065 |
| Provider Name | Jamie Tyler Couch |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659923282 PECOS PAC ID: 1951630086 Enrollment ID: I20190913002927 |
| Provider Name | Alicia R Register |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1356789473 PECOS PAC ID: 9739400839 Enrollment ID: I20190918001283 |
| Provider Name | Charla R Mcgaha |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487200176 PECOS PAC ID: 7416380746 Enrollment ID: I20191127001308 |
| Provider Name | Jenifer E Taylor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053960666 PECOS PAC ID: 8325471998 Enrollment ID: I20191212001586 |
| Provider Name | Dakota L Miller |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760020523 PECOS PAC ID: 0648606731 Enrollment ID: I20200210000713 |
| Provider Name | Corlynda J Bloodworth |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538793724 PECOS PAC ID: 7719317361 Enrollment ID: I20200422000402 |
| Provider Name | Shaun Franklin |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1063451656 PECOS PAC ID: 8123090446 Enrollment ID: I20200520002406 |
| Provider Name | Odianosen Obadan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1902200835 PECOS PAC ID: 3375803265 Enrollment ID: I20200721003677 |
| Provider Name | Matthew B Barksdale |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821606492 PECOS PAC ID: 3678999307 Enrollment ID: I20200812001978 |
| Provider Name | Venu Velagapudi |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1629264320 PECOS PAC ID: 2264688209 Enrollment ID: I20200826002402 |
| Provider Name | Cyrenah Lane |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1205360021 PECOS PAC ID: 7012281181 Enrollment ID: I20200902003553 |
| Provider Name | Rachel Parker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467062620 PECOS PAC ID: 4880011105 Enrollment ID: I20210420002201 |
| Provider Name | Judy Lynn Fajardo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811548597 PECOS PAC ID: 7911306204 Enrollment ID: I20210518001882 |
| Provider Name | Detra Kerr Dixon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376101196 PECOS PAC ID: 3375948003 Enrollment ID: I20210818003627 |
| Provider Name | Leonardo Luis Zelaya Castillo |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1316444755 PECOS PAC ID: 6608272489 Enrollment ID: I20210901003906 |
| Provider Name | Monica Helton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376199497 PECOS PAC ID: 4789072497 Enrollment ID: I20211029001717 |
| Provider Name | Joseph Sonntag |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1063038388 PECOS PAC ID: 8325439938 Enrollment ID: I20211215000964 |
| Provider Name | Gaboy Jupiter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033656715 PECOS PAC ID: 0648554758 Enrollment ID: I20220309000909 |
| Provider Name | Tracey K Williams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588118251 PECOS PAC ID: 0840571279 Enrollment ID: I20220404001910 |
| Provider Name | Summer Morrow |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508597477 PECOS PAC ID: 5395127542 Enrollment ID: I20220804000240 |
| Provider Name | Ginny D Tejeda |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972238020 PECOS PAC ID: 0042692147 Enrollment ID: I20220805002684 |
| Provider Name | Michael Sonntag |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1831765478 PECOS PAC ID: 0143603332 Enrollment ID: I20220822000978 |
| Provider Name | Randy Lavender |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1841637378 PECOS PAC ID: 5496996688 Enrollment ID: I20221013000385 |
| Provider Name | Mitchell Austin |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1639288749 PECOS PAC ID: 5698861094 Enrollment ID: I20221228003201 |
| Provider Name | Lauren Cravey Speight |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306556261 PECOS PAC ID: 7618349879 Enrollment ID: I20230216000801 |
| Provider Name | Juan S Serna-gonzalez |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1700402013 PECOS PAC ID: 0446615306 Enrollment ID: I20230427001475 |
| Provider Name | Shelby Dozier Eubanks |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902367980 PECOS PAC ID: 2668839846 Enrollment ID: I20230602000581 |
| Provider Name | Ryan Bradley Davies |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1407353246 PECOS PAC ID: 0840542015 Enrollment ID: I20230602000831 |
| Provider Name | Wendy M Thompson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629752274 PECOS PAC ID: 0244691004 Enrollment ID: I20230727000093 |
| Provider Name | Megan Broadwater |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407539398 PECOS PAC ID: 4385098375 Enrollment ID: I20230925002405 |
| Provider Name | Jennifer Atkins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598533119 PECOS PAC ID: 3779933874 Enrollment ID: I20240102003539 |
| Provider Name | Xavier Capalla |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1417523093 PECOS PAC ID: 7719325364 Enrollment ID: I20240402003465 |
| Provider Name | Mohamed Elgendy |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1902447535 PECOS PAC ID: 0648501015 Enrollment ID: I20240508000922 |
| Provider Name | Carmen Sylvia Simmons |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1417534553 PECOS PAC ID: 0042757650 Enrollment ID: I20240731004329 |
| Provider Name | Anne Lombardi |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1164721668 PECOS PAC ID: 8123345881 Enrollment ID: I20250228003198 |
Careconnect Health, Inc. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1007 E 16th Ave, Suite A, Cordele, GA 31015 Phone: 229-273-1716 Fax: 229-273-1720 | |
Holloway Internal Medicine Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 415 E 4th Ave Ste B, Cordele, GA 31015 Phone: 229-276-2190 Fax: 229-276-3639 | |
Adams Clinical Services, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 408 E 16th Ave Ste B, Cordele, GA 31015 Phone: 229-273-3433 Fax: 229-273-0580 | |
M D Whitest Medical Institute Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 401 N 15th St, Cordele, GA 31015 Phone: 404-751-7207 | |
Albany Pulmonary And Critical Care, P.c. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 214 E 4th Ave, Cordele, GA 31015 Phone: 229-438-5864 | |
Careconnect Health, Inc. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 711 E 16th Ave, Cordele, GA 31015 Phone: 229-271-9330 Fax: 229-271-9245 | |
Rahhal Gastroenterology Associates, Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 910 N 5th St, Cordele, GA 31015 Phone: 229-276-2185 Fax: 229-276-2186 |