Wheeler County Family Medicine

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

037085 Issued in GA

Legal business name

WHEELER COUNTY FAMILY MEDICINE

Practice address

104 Maple Dr
Vidalia, GA 30474-8949

Phone

(912) 537-0616

Fax

(912) 537-0617

NPI assigned

Jun 20, 2007

Last updated

Feb 3, 2010By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Odell P Still, D.O.

Title

Medical Director

Phone

(912) 537-0616

Specialties & licenses 1

Addresses

Other identifiers 8

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Tony Bevill, P.A.-C

  • Medical Physician Assistant
  • Collins, GA
  • NPI 1255324489
  NPD (past)
• Nina Sheria Lagarde, NP

  • Family Nurse Practitioner
  • Douglasville, GA
  • NPI 1033201918
  NPD (past)
• Catherine W Reavis, FNP

  • Nurse Practitioner
  • Lyons, GA
  • NPI 1750374336
  NPD (past)
• Stephanie C Trammel, PHD, APRN, BC, FAAN

  • Family Nurse Practitioner
  • Greenville, SC
  • NPI 1073549085
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1182297600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1265155200000",
    "number": "1033314711",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 MAPLE DR",
            "city": "VIDALIA",
            "state": "GA",
            "postal_code": "304748949",
            "telephone_number": "912-537-0616",
            "fax_number": "912-537-0617"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 MAPLE DR",
            "city": "VIDALIA",
            "state": "GA",
            "postal_code": "304748949",
            "telephone_number": "912-537-0616",
            "fax_number": "912-537-0617"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WHEELER COUNTY FAMILY MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-20",
        "last_updated": "2010-02-03",
        "status": "A",
        "authorized_official_last_name": "STILL",
        "authorized_official_first_name": "ODELL",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "912-537-0616",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "037085",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000347751C",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000539624E",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000539624K",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000631474A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "393478520A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000954533C",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "644701462A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "091222821A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Leah M Waller, PA
• Deborah Ward, L.P.C.
• Carl Anthony Wardlaw, LPC
• Kimberly Rae Warren, MSN, APRN, AGPCNP-BC
• Weber Therapy Associates, Inc.
• Oliver Cleveland Whipple, R.PH.
• Zachary Jordan Whitaker, PA
• White Medical Services, PC
• Laura H White, PMHNP, FNP-C
• Leigh-Anne White, LPC

• Family Medicine Physician in Vidalia, GA
• Providers in Vidalia, GA by specialty
• Family Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.