Meadows Regional Medical Center, Inc.

Key facts

NPI: 1467091389
Entity type: Organization (NPI type 2)
Primary specialty: Mammography Clinic/Center 261QR0206X
Legal business name: MEADOWS REGIONAL MEDICAL CENTER, INC.
Practice address: 1707 Meadows LN Ste B
Vidalia, GA 30474-7201
Phone: (912) 535-7100
Fax: (912) 535-7120
NPI assigned: Dec 23, 2019
Organization subpart: Yes
Parent organization (as reported): MEADOWS REGIONAL MEDICAL CENTER

Authorized official

Name: Tony M O'Steen
Title: Cfo
Phone: (912) 535-8691

National Provider Directory

Part of: Meadows Dia Ctr of Savan

Locations

368 S Main St
Baxley, GA 31513
Phone (912) 366-1981

104 Fairview Park Dr
Ste A
Dublin, GA 31021
Phone (478) 396-6237

247 W Main St
Ste A
Swainsboro, GA 30401
Phone (478) 237-3425

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Mammography Clinic/Center	261QR0206X			Yes

Addresses

Primary practice location

1707 Meadows LN Ste B
Vidalia, GA 30474-7201

Mailing address

PO Box 407
Vidalia, GA 30475-0407
Phone (912) 535-5581

Other identifiers

Identifier	Type	State	Issuer
000001086A	Medicaid	GA

Other names

Meadows Imaging Center Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Dec 23, 2019.

{
    "created_epoch": "1577059200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1577059200000",
    "number": "1467091389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 407",
            "city": "VIDALIA",
            "state": "GA",
            "postal_code": "304750407",
            "telephone_number": "912-535-5581"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1707 MEADOWS LN STE B",
            "city": "VIDALIA",
            "state": "GA",
            "postal_code": "304747201",
            "telephone_number": "912-535-7100",
            "fax_number": "912-535-7120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEADOWS REGIONAL MEDICAL CENTER, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MEADOWS REGIONAL MEDICAL CENTER",
        "enumeration_date": "2019-12-23",
        "last_updated": "2019-12-23",
        "certification_date": "2019-12-23",
        "status": "A",
        "authorized_official_last_name": "O'STEEN",
        "authorized_official_first_name": "TONY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "912-535-8691"
    },
    "taxonomies": [
        {
            "code": "261QR0206X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology, Mammography",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000001086A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Meadows Imaging Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Vidalia, GA

All providers in Vidalia, GA · Mammography Clinic/Center in Georgia

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 23, 2019. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.