Baldwin Emergency Group, LLC
Organization Active NPI Emergency Medicine Physician · Milledgeville, GA
NPI 1306206826 · NPPES record last updated Mar 23, 2022
Key facts
- NPI
- 1306206826
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Emergency Medicine Physician 207P00000X
- Legal business name
- BALDWIN EMERGENCY GROUP, LLC
- Practice address
- 821 N Cobb St
Milledgeville, GA 31061-2343 - Phone
- (478) 454-3500
- NPI assigned
- Feb 25, 2016
- Organization subpart
- No
Authorized official
- Name
- Lisha Falk
- Title
- VP of Contracting
- Phone
- (337) 609-1221
Practitioners 68
-
Kalli Pelar Coleman Addison, ATC/LAT, EMT-I
-
Parker Rhett Blizzard, FNP-C
-
Sophenia Rebecca Gay, M.D.
-
Nawar R Hajo, M.D.
-
James Lawrence III, M.D.
-
Vijay K. Mahathre, M.D.
-
James C Thigpen Jr., M.D.
-
Paulo Souza Silva, M.D.
-
Juan Villegas, MD
-
Kara A Kelsey, MD
-
Keith A Blanks, D.O
-
Tonya M Burnett, NP-C
-
Laura Cheshire, NP
-
Jaykrishna Darji, M.D.
-
Anna H Ethridge, NP-C
-
Wendy Brannan Fuller, FNP
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20160615000222 | GA | Part B Supplier - Clinic/Group Practice | 7012208408 |
Receives reassigned benefits from 64 practitioners Practice locations: Milledgeville, GA |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician |
207P00000X | Yes | ||
| Physician Assistant |
363A00000X | |||
| Nurse Practitioner |
363L00000X |
Addresses
Primary practice location
821 N Cobb St
Milledgeville, GA 31061-2343
Mailing address
200 Corporate Blvd
Lafayette, LA 70508-3870
Phone (800) 893-9698
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 003175971A | Medicaid | GA | |
| 2027G07231 | Other | GA | MEDICARE OF GEORGIA |
Other providers in Milledgeville, GA
- Baldwin County Board of Education
- Baldwin County EMS
- Baldwin County Health Department
- Baldwin County Nursing Home LLC
- Baldwin Dialysis Center LLC
- Baldwin Medical Center
- Baldwin Physician Services, LLC
- Misty Nicole Banknell
- Barbarakares of East Georgia Inc.
- Barbarakares of Greater Atlanta Inc.
All providers in Milledgeville, GA · Emergency Medicine Physician in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 23, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.