Charlton Family Care, Inc

Key facts

NPI

1598032112

Entity type

Organization (NPI type 2)

Primary specialty

Internal Medicine Physician 207R00000X

License

55077 (GA)

Legal business name

CHARLTON FAMILY CARE, INC

Practice address

190 Austin Ryan Dr
Kingsland, GA 31548-6191

Phone

(917) 288-6765

NPI assigned

Nov 28, 2011

Organization subpart

No

Authorized official

Name

Dr. Maged Edward Abdelmalik, M.D. NPI 1770558470

Title

President

Phone

(917) 288-6765

Authorized official NPPES reports the authorized official by name only; the link goes to the one practitioner connected to this organization with that name.

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Maged Edward Abdelmalik, M.D. Internal Medicine Physician · Folkston, GA · NPI 1770558470
  NPD Authorized official INTERNAL MEDICINE
• Morgan Mizell Eldridge, APRN Family Nurse Practitioner · Waycross, GA · NPI 1639660087
  NPD (past)
• Betsy Erin Tanner, MSN-FNP, BC Nurse Practitioner · Waycross, GA · NPI 1295387751
  NPD (past)

National Provider Directory

Locations

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Nov 28, 2011.

{
    "created_epoch": "1322438400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1322438400000",
    "number": "1598032112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "190 AUSTIN RYAN DR",
            "city": "KINGSLAND",
            "state": "GA",
            "postal_code": "315486191",
            "telephone_number": "917-288-6765"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "190 AUSTIN RYAN DR",
            "city": "KINGSLAND",
            "state": "GA",
            "postal_code": "315486191",
            "telephone_number": "917-288-6765"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHARLTON FAMILY CARE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-11-28",
        "last_updated": "2011-11-28",
        "status": "A",
        "authorized_official_last_name": "ABDELMALIK",
        "authorized_official_first_name": "MAGED",
        "authorized_official_middle_name": "EDWARD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "917-288-6765",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "55077",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Ryan Manning Clements

All providers in Kingsland, GA · Internal Medicine Physician in Georgia