NPIMap

Organization Active NPI

Meadows Regional Medical Center

  • Athletic Trainer
  • Vidalia, GA
National Provider Identifier
1184697245
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
AT000250 Issued in GA
Legal business name
MEADOWS REGIONAL MEDICAL CENTER
Practice address
101 Harris Industrial Blvd
Vidalia, GA 30474-8845
Phone
(912) 277-2035
Fax
(912) 277-2098
NPI assigned
Feb 9, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Nancy W Stanley
Title
Director of Rehab
Phone
(912) 277-2034

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic TrainerGroup: 193200000X MULTI-SPECIALTY GROUP 2255A2300X AT000250 GA Primary

Addresses

Primary practice location

101 Harris Industrial Blvd
Vidalia, GA 30474-8845

Mailing address

724 Chesley Dr
Vidalia, GA 30474-5516
Phone (912) 537-1590

National Provider Directory

National Provider Directory
Tax ID family
Meadows Imaging Center3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1139443200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1184697245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "724 CHESLEY DR",
            "city": "VIDALIA",
            "state": "GA",
            "postal_code": "304745516",
            "telephone_number": "912-537-1590"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 HARRIS INDUSTRIAL BLVD",
            "city": "VIDALIA",
            "state": "GA",
            "postal_code": "304748845",
            "telephone_number": "912-277-2035",
            "fax_number": "912-277-2098"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEADOWS REGIONAL MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-09",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "STANLEY",
        "authorized_official_first_name": "NANCY",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "DIRECTOR OF REHAB",
        "authorized_official_telephone_number": "912-277-2034"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "GA",
            "license": "AT000250",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vidalia, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.