Josefina Cathryn Abendan Dubberly, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

057562 Issued in GA

Practice address

105 E Tollison St Ste D
Baxley, GA 31513-0150

Phone

(912) 366-9688

Fax

(912) 366-9888

NPI assigned

Dec 1, 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

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: josephina.abendan@ahcs.eclinicaldirectplus.com

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.

• The Baxley and Appling County Hospital Authority

  • General Practice Physician
  • Baxley, GA
  • NPI 1518967116

  GA

  Medicare reassignment NPD
• The Baxley and Appling County Hospital Authority

  • Surgery Physician
  • Baxley, GA
  • NPI 1376897488
  NPD
• The Baxley and Appling County Hospital Authority

  • Rural Health Clinic/Center
  • Baxley, GA
  • NPI 1073752143
  NPD (past)

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

{
    "created_epoch": "1164931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1124196928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2070",
            "city": "BAXLEY",
            "state": "GA",
            "postal_code": "315152070",
            "telephone_number": "912-367-9841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 E TOLLISON ST STE D",
            "city": "BAXLEY",
            "state": "GA",
            "postal_code": "315130150",
            "telephone_number": "912-366-9688",
            "fax_number": "912-366-9888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABENDAN DUBBERLY",
        "first_name": "JOSEFINA",
        "middle_name": "CATHRYN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-01",
        "last_updated": "2023-03-07",
        "certification_date": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "GA",
            "license": "057562",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• 912 Healthcare, LLC
• Abundant Life Pharmacy & Health Foods Inc
• Abundant Life Pharmacy & Health Foods Inc
• Jessica Marie Alferink, FNP
• Juan Alexander Alonso, MS,LAT,ATC
• Altamaha Homecare, Inc.

• All providers in Baxley, GA
• Pediatrics Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.