Jose Medina MD PC

Primary specialty

Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X

License

041166 Issued in GA

Legal business name

JOSE MEDINA MD PC

Practice address

3334 Greystone Way
Valdosta, GA 31605-1096

Phone

(229) 247-1667

Fax

(229) 247-3456

NPI assigned

Aug 7, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Jose Medina, MDNPI 1417944513

Title

Owner

Phone

(229) 247-1667

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jose Medina, MD

  • Pulmonary Disease Physician
  • Valdosta, GA
  • NPI 1417944513
  Medicare reassignment Care Compare group Authorized official
• Jose Gabriel Medina Smester, M.D.

  • Internal Medicine Physician
  • Miami, FL
  • NPI 1295053593

  GA, Multi-Specialty

  Medicare reassignment Care Compare group NPD
• Richard Glynn Cooper, M.D.

  • Diagnostic Radiology Physician
  • Valdosta, GA
  • NPI 1467433573
  NPD (past)
• Felix G Valdez, MD

  • Internal Medicine Physician
  • Valdosta, GA
  • NPI 1023005121
  NPD (past)

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

{
    "created_epoch": "1186444800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1276560000000",
    "number": "1407047269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3550",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316043550",
            "telephone_number": "229-247-1667",
            "fax_number": "229-247-3456"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3334 GREYSTONE WAY",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316051096",
            "telephone_number": "229-247-1667",
            "fax_number": "229-247-3456"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOSE MEDINA MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-07",
        "last_updated": "2010-06-15",
        "status": "A",
        "authorized_official_last_name": "MEDINA",
        "authorized_official_first_name": "JOSE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "229-247-1667",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "GA",
            "license": "041166",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00686507C",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Haley N Jordan
• Mikeal Jordan
• Millie Jordan, NP
• Myra Jordan, LMFT
• William Anthony Jordan, CERTIFIED COUNSELOR
• Joseph L Kirbo Jr
• Joseph S Thomas M D
• Kimberly Joseph
• Patrick Joseph, MD
• Lauren Hudson Jovovic, M.A., CCC-SLP

• Multi-Specialty Clinic/Center in Valdosta, GA
• Providers in Valdosta, GA by specialty
• Multi-Specialty Clinic/Center in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2010; 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.