NPIMap

Individual provider Active NPI

George Sidney Staton, M.D.

  • Cardiovascular Disease Physician
  • Valdosta, GA
National Provider Identifier
1215990098
Registry record updated Mar 17, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
63539 Issued in GA
Practice address
410 Connell Road
Valdosta, GA 31602
Phone
(229) 244-4720
Fax
(229) 316-0471
NPI assigned
Apr 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 2006-00103 NC
Cardiovascular Disease Physician 207RC0000X 63539 GA Primary

Addresses

Primary practice location

410 Connell Road
Valdosta, GA 31602

Mailing address

410 Connell Rd
Valdosta, GA 31602-1898
Phone (229) 244-4720

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100713000194 GA Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 4587796404 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Internal Medicine
Education
Mercer University School of Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
South Georgia Medical Center IncGroup PAC ID 1052764677, 58 clinicians
South Georgia Medical Associates, PCGroup PAC ID 4385601798, 5 clinicians

Practice addresses (Care Compare)

2501 N Patterson St
Valdosta, GA 31602-1735
Phone (229) 259-4291

410 Connell Rd
Valdosta, GA 31602-1898
Phone 2292444720102

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting56
Pacemaker insertion or repair30

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
2006-00103NCMDInternal Medicine Physician
63539GAMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
South Georgia Medical Center Inc CurrentSince Jun 1, 2024 Accepting new patients
South Georgia Medical Center Inc CurrentSince Jun 1, 2024 Accepting new patients
South Georgia Medical Associates, PC Internal Medicine CurrentSince Jul 1, 2010 Accepting new patients
Hospital Authority of Valdosta and Lowndes County Georgia CurrentSince Nov 9, 2010 Accepting new patients
Hospital Authority of Valdosta and Lowndes County Georgia Current Accepting new patients
Hospital Authority of Valdosta and Lowndes County, Georgia CurrentSince Nov 9, 2010 Accepting new patients

Locations

4280 N Valdosta Rd
Valdosta, GA 31602
Phone (229) 433-7350

2501 N Patterson St
Valdosta, GA 31602
Phone (229) 259-4139

410 Connell Rd
Valdosta, GA 31602
Phone (229) 244-1570

Interoperability endpoints

  • Direct secure messaging: george.staton@sgma.directbygreenway.com

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 5

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": "1144713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1395014400000",
    "number": "1215990098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "410 CONNELL RD",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316021898",
            "telephone_number": "229-244-4720",
            "fax_number": "229-316-0471"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 CONNELL ROAD",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "31602",
            "telephone_number": "229-244-4720",
            "fax_number": "229-316-0471"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STATON",
        "first_name": "GEORGE",
        "middle_name": "SIDNEY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-11",
        "last_updated": "2014-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "2006-00103",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "GA",
            "license": "63539",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Valdosta, GA

Sources for this page

Verify at the official NPI Registry.