Minerva Villafane, MD

Primary specialty

Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X

License

MD439863 Issued in PA

Practice address

Pathways Center
122-C Gordon Commercial Dr
Lagrange, GA 30240-5754

Phone

(706) 845-4045

Fax

(706) 845-4367

NPI assigned

Feb 16, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Minerva Villafane-Garcia Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Family Behavioral Care of Central Ga, PC

  • Psychiatry Physician
  • Macon, GA
  • NPI 1003863788

  Child & Adolescent Psychiatry

  NPD (past)
• Pathways Center for Behavioral & Developmental Growth

  • Community/Behavioral Health Agency
  • Newnan, GA
  • NPI 1407492846
  NPD (past)
• Pathways Center for Behavioral and Developmental Growth

  • Community/Behavioral Health Agency
  • Newnan, GA
  • NPI 1013289255
  NPD (past)

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

{
    "created_epoch": "1140048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531180800000",
    "number": "1073587895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1428 CANDLEWYCKE DR",
            "city": "MIDDLETOWN",
            "state": "PA",
            "postal_code": "170572900",
            "telephone_number": "478-320-6269",
            "fax_number": "717-939-2503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "PATHWAYS CENTER",
            "address_2": "122-C GORDON COMMERCIAL DR",
            "city": "LAGRANGE",
            "state": "GA",
            "postal_code": "302405754",
            "telephone_number": "706-845-4045",
            "fax_number": "706-845-4367"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8 E Cottonwood St Bldg C",
            "address_purpose": "LOCATION",
            "city": "Cottonwood",
            "state": "AZ",
            "postal_code": "863266237",
            "country_code": "US",
            "telephone_number": "928-634-2236",
            "fax_number": "928-634-8960",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VILLAFANE",
        "first_name": "MINERVA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-16",
        "last_updated": "2018-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "PA",
            "license": "MD439863",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000856413A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MINERVA",
            "last_name": "VILLAFANE-GARCIA",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Child & Adolescent Psychiatry Physician in Lagrange, GA
• Providers in Lagrange, GA by specialty
• Child & Adolescent Psychiatry Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2018; 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.