Odell Still DO LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

ODELL STILL DO LLC

Doing business as

Southeast Regional Primary Care Corp

Practice address

28 W Railroad Ave
Alamo, GA 30411-3513

Phone

(912) 568-1407

Fax

(912) 568-1579

NPI assigned

Aug 30, 2010

Last updated

Sep 15, 2015By the provider in NPPES

Organization subpart

Yes

Parent organization

SOUTHEAST REGIONAL PRIMARY CARE CORPORATIONAs reported in NPPES

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

Authorized official

Name

Tony M Osteen

Title

Cfo

Phone

(912) 538-5314

Specialties & licenses 1

Addresses

Other names 1

• Southeast Regional Primary Care Corp Doing business as

Part of

Southeast Regional Primary Care Corporation

Practitioners 1

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.

• Rosemary Bergeron-Johnson, PAC

  • Physician Assistant
  • Yakima, WA
  • NPI 1043255318
  NPD (past)

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

{
    "created_epoch": "1283126400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1442275200000",
    "number": "1033425962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 407",
            "city": "VIDALIA",
            "state": "GA",
            "postal_code": "304750407",
            "telephone_number": "912-537-4986"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28 W RAILROAD AVE",
            "city": "ALAMO",
            "state": "GA",
            "postal_code": "304113513",
            "telephone_number": "912-568-1407",
            "fax_number": "912-568-1579"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ODELL STILL DO LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SOUTHEAST REGIONAL PRIMARY CARE CORPORATION",
        "enumeration_date": "2010-08-30",
        "last_updated": "2015-09-15",
        "status": "A",
        "authorized_official_last_name": "OSTEEN",
        "authorized_official_first_name": "TONY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "912-538-5314"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Southeast Regional Primary Care Corp",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Austin Keith Barrows, MSN, FNP-C
• Careconnect Health, Inc. (CareConnect Family Practice)
• Lindsay Joann Douglas, COTA/L
• Laurie Frank, PA-C
• Amy Diane Harris, MS
• Sarah Frances Selph, RN
• William Stephen Sightler, D.O.
• Terissa Hughes Watkins, RN
• Wheeler County Board of Education
• Wheeler County Health Department

• Family Medicine Physician in Alamo, GA
• Providers in Alamo, 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 Sep 15, 2015; 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.