Individual provider Active NPI

Nicholas Brian Dodson, D.P.M.

  • Podiatrist
  • Valdosta, GA
National Provider Identifier
1144544842
Registry record updated May 18, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
POD001131 Issued in GA
Practice address
4370 Kings Way
Suite B
Valdosta, GA 31602-6904
Phone
(229) 244-0070
Fax
(229) 244-0080
NPI assigned
Mar 24, 2010
Last updated
May 18, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 18, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X POD001131 GA Primary

Addresses

Primary practice location

4370 Kings Way
Suite B
Valdosta, GA 31602-6904

Mailing address

4370 Kings Way
Suite B
Valdosta, GA 31602-6904
Phone (229) 244-0070

Medicare participation

Medicare enrollment files
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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100628000798 GA Practitioner - Podiatry 7719018233 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sterling Podiatry LLCGroup PAC ID 4688045982, 2 clinicians

Practice addresses (Care Compare)

3 Magnolia CT
Moultrie, GA 31768-6764
Phone (229) 891-9028

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue40
Removal of nail tissue80
Removal or shaving of skin growth19

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
POD001131GAMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Sterling Podiatry LLC Podiatrist CurrentSince Jan 1, 2023 Accepting new patients
Colquitt Regional Medical Center CurrentSince Apr 20, 2024 Accepting new patients
Colquitt Regional Medical Center Current Accepting new patients
Colquitt Regional Pathology, LLC Current Accepting new patients
Colquitt Regional Medical Center CurrentSince Apr 20, 2024 Accepting new patients
Hospital Authority of the City of Bainbridge and Decatur County Past Accepting new patients

Locations

2 Hospital Park
Moultrie, GA 31768
Phone (229) 391-4130

3 Magnolia Ct
Moultrie, GA 31768
Phone (229) 225-1900

3131 Thomasville Hwy
Moultrie, GA 31768
Phone (229) 502-9769

Organizations & group practices 6

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

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1269388800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1274140800000",
    "number": "1144544842",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4370 KINGS WAY",
            "address_2": "SUITE B",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316026904",
            "telephone_number": "229-244-0070",
            "fax_number": "229-244-0080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4370 KINGS WAY",
            "address_2": "SUITE B",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316026904",
            "telephone_number": "229-244-0070",
            "fax_number": "229-244-0080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DODSON",
        "first_name": "NICHOLAS",
        "middle_name": "BRIAN",
        "name_prefix": "Dr.",
        "credential": "D.P.M.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-03-24",
        "last_updated": "2010-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "GA",
            "license": "POD001131",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Valdosta, GA

Sources for this page

Verify at the official NPI Registry.