Valdosta Family Medicine Associates, P.C.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

045725 Issued in GA

Legal business name

VALDOSTA FAMILY MEDICINE ASSOCIATES, P.C.

Doing business as

Valdosta Family Medicine

Practice address

2412 N Oak St
Valdosta, GA 31602-2567

Phone

(229) 244-1400

Fax

(229) 244-5512

NPI assigned

Oct 27, 2006

Last updated

Dec 28, 2021By 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

Craig E Bishop, D.O.NPI 1679655492

Title

Managing Partner

Phone

(229) 244-1400

Specialties & licenses 13

Addresses

Other identifiers 2

Other names 1

• Valdosta Family Medicine Doing business as

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/CHFDAA

Practitioners 50

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.

• Craig E Bishop, D.O.

  • Family Medicine Physician
  • Valdosta, GA
  • NPI 1679655492
  Medicare reassignment Care Compare group NPD Authorized official
• Kimberly Davis Bennett, NP-C

  • Nurse Practitioner
  • Homerville, GA
  • NPI 1457036857
  Medicare reassignment Care Compare group NPD
• Robert Daniel Bennett, MD

  • Family Medicine Physician
  • Valdosta, GA
  • NPI 1023456290
  Medicare reassignment Care Compare group NPD
• Elizabeth Ann Bostic, FNP-C

  • Family Nurse Practitioner
  • Valdosta, GA
  • NPI 1881372522
  Medicare reassignment Care Compare group NPD
• Pollyanna Marie Boykin, FNP-C

  • Family Nurse Practitioner
  • Valdosta, GA
  • NPI 1811018153
  Medicare reassignment Care Compare group NPD
• Marlon Charles, FNP-C

  • Family Nurse Practitioner
  • Valdosta, GA
  • NPI 1083409676
  Medicare reassignment Care Compare group NPD
• Hunter L Clanton, FNP-C

  • Family Nurse Practitioner
  • Valdosta, GA
  • NPI 1447967575
  Medicare reassignment Care Compare group NPD
• Gary-Wayne Luke Collins, FNP-C

  • Family Nurse Practitioner
  • Valdosta, GA
  • NPI 1164205183
  Medicare reassignment Care Compare group NPD
• Tracy Christine Creed, FNP-BC

  • Family Nurse Practitioner
  • Valdosta, GA
  • NPI 1912157272
  Medicare reassignment Care Compare group NPD
• Sarah Goodman Fender, FNP-C

  • Nurse Practitioner
  • Valdosta, GA
  • NPI 1447821129
  Medicare reassignment Care Compare group NPD
• Jordan Ganas

  • Family Nurse Practitioner
  • Valdosta, GA
  • NPI 1972093185
  Medicare reassignment Care Compare group NPD
• Anna Vaggalis Grant, FNP-C

  • Family Nurse Practitioner
  • Valdosta, GA
  • NPI 1558846121
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1161907200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1640649600000",
    "number": "1114003779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2412 N OAK ST",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316022567",
            "telephone_number": "229-244-1400",
            "fax_number": "229-244-5512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2412 N OAK ST",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316022567",
            "telephone_number": "229-244-1400",
            "fax_number": "229-244-5512"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VALDOSTA FAMILY MEDICINE ASSOCIATES, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-27",
        "last_updated": "2021-12-28",
        "certification_date": "2021-12-28",
        "status": "A",
        "authorized_official_last_name": "BISHOP",
        "authorized_official_first_name": "CRAIG",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "229-244-1400",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "003072",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "004849",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "004094",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN154901",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "CHIRO02539",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "045725",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "029930",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "029951",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "030242",
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "GA",
            "license": "044001",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "GA",
            "license": "041290",
            "primary": false
        },
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "GA",
            "license": "041978",
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "GA",
            "license": "008563",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "GRP1391",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "55001045A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Valdosta Family Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Valdosta Chiropractic & Rehab, LLC
• Valdosta City Board of Education
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• Valdosta Family Dentistry
• Valdosta Foot & Ankle Clinic, P.C.
• Valdosta Foot & Ankle Surgery Center, P.C.
• Valdosta Gastroenterology Associates, LLC
• Valdosta Health & Wellness Clinic Inc
• Valdosta Healthcare Club

• Family Medicine Physician in Valdosta, GA
• Providers in Valdosta, 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 Dec 28, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.