NPIMap

Organization Active NPI

South Health District

  • Public Health or Welfare Agency
  • Valdosta, GA
National Provider Identifier
1366685307
Registry record updated Dec 14, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Public Health or Welfare AgencyTaxonomy code 251K00000X
Legal business name
SOUTH HEALTH DISTRICT
Practice address
312 N Patterson St
Valdosta, GA 31601-5526
Phone
(229) 333-7585
Fax
(229) 333-7591
NPI assigned
Apr 7, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2009

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

Authorized official

Name
Dr. Lynne Feldman, MD, MBA
Title
Medical Director
Phone
(229) 333-5290

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Public Health or Welfare Agency 251K00000X Primary

Addresses

Primary practice location

312 N Patterson St
Valdosta, GA 31601-5526

Mailing address

251 Appomattox Rd
Fitzgerald, GA 31750-3757
Phone (229) 333-7585

Other identifiers 2

IdentifierTypeStateIssuer
FLU211OtherGAMEDICARE PART B
000052038BMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050825000504 GA Part B Supplier - Mass Immunization (Roster Biller Only) 0648255018 13 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Lakeland, GA; Valdosta, GA; Tifton, GA; Statenville, GA; Quitman, GA; Ocilla, GA; Lake Park, GA; Hahira, GA…

Other NPIs on the same Medicare enrollment 13

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 13

National Provider Directory

National Provider Directory

Locations

251 Appomattox Rd
Fitzgerald, GA 31750
Phone (229) 426-5288

314 N Patterson St
Valdosta, GA 31601
Phone (229) 249-2794

NPI Registry JSON

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

{
    "created_epoch": "1239062400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1260748800000",
    "number": "1366685307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "251 APPOMATTOX RD",
            "city": "FITZGERALD",
            "state": "GA",
            "postal_code": "317503757",
            "telephone_number": "229-333-7585",
            "fax_number": "229-333-7591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "312 N PATTERSON ST",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316015526",
            "telephone_number": "229-333-7585",
            "fax_number": "229-333-7591"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH HEALTH DISTRICT",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-04-07",
        "last_updated": "2009-12-14",
        "status": "A",
        "authorized_official_last_name": "FELDMAN",
        "authorized_official_first_name": "LYNNE",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "229-333-5290",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD, MBA"
    },
    "taxonomies": [
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PART B",
            "identifier": "FLU211",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000052038B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Valdosta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.