NPIMap

Organization Active NPI

Ear, Nose, Throat, and Allergy Associates of South Georgia PC

  • Plastic Surgery within the Head & Neck (Otolaryngology) Physician
  • Valdosta, GA
National Provider Identifier
1629086327
Registry record updated Nov 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery within the Head & Neck (Otolaryngology) PhysicianTaxonomy code 207YX0007X
Legal business name
EAR, NOSE, THROAT, AND ALLERGY ASSOCIATES OF SOUTH GEORGIA PC
Practice address
2910 N Patterson St
Valdosta, GA 31602-1720
Phone
(229) 244-2562
Fax
(229) 249-0000
NPI assigned
Aug 4, 2006
Last updated
Nov 10, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2023

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

Authorized official

Name
Mr. Ronald Vann Allen, M.D.NPI 1831162049
Title
President
Phone
(229) 244-2562

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery within the Head & Neck (Otolaryngology) Physician 207YX0007X Primary

Addresses

Primary practice location

2910 N Patterson St
Valdosta, GA 31602-1720

Mailing address

2910 N Patterson St
Valdosta, GA 31602-1720
Phone (229) 244-2562

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040521000609 GA Part B Supplier - Clinic/Group Practice 0941291520 Receives reassigned benefits from 9 practitioners
Practice locations: Valdosta, GA

National Provider Directory

National Provider Directory

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1154649600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1699574400000",
    "number": "1629086327",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2910 N PATTERSON ST",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316021720",
            "telephone_number": "229-244-2562",
            "fax_number": "229-249-0000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2910 N PATTERSON ST",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316021720",
            "telephone_number": "229-244-2562",
            "fax_number": "229-249-0000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAR, NOSE, THROAT, AND ALLERGY ASSOCIATES OF SOUTH GEORGIA PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-04",
        "last_updated": "2023-11-10",
        "certification_date": "2023-11-10",
        "status": "A",
        "authorized_official_last_name": "ALLEN",
        "authorized_official_first_name": "RONALD",
        "authorized_official_middle_name": "VANN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "229-244-2562",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207YX0007X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Plastic Surgery within the Head & Neck",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Nov 10, 2023; 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.