NPIMap

Organization Active NPI

Hospital Authority of Valdosta and Lowndes County Georgia

Doing business as Smith Northview Hospitalists

  • Hospitalist Physician
  • Valdosta, GA
National Provider Identifier
1629346390
Registry record updated Mar 28, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
Legal business name
HOSPITAL AUTHORITY OF VALDOSTA AND LOWNDES COUNTY GEORGIA
Doing business as
Smith Northview Hospitalists
Practice address
4280 N Valdosta Rd
Valdosta, GA 31602-6814
Phone
(229) 671-2000
Fax
(229) 671-2054
NPI assigned
Dec 8, 2011
Organization subpart
Yes
Parent organization
HOSPITAL AUTHORITY OF VALDOSTA AND LOWNDES COUNTY GEORGIAAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 28, 2013

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

Authorized official

Name
Mr. Jack Randall Sauls
Title
Chief Executive Officer
Phone
(229) 333-1020

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208M00000X Primary

Addresses

Primary practice location

4280 N Valdosta Rd
Valdosta, GA 31602-6814

Mailing address

4280 N Valdosta Rd
Valdosta, GA 31602-6814
Phone (229) 671-2000

Other names 1

  • Smith Northview Hospitalists Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040405001313 GA Part B Supplier - Clinic/Group Practice 1355334509 Receives reassigned benefits from 114 practitioners
13 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Valdosta, GA; Nashville, GA; Lakeland, 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
Tax ID family
Southe Georgia Medical13 organizations share this tax ID, including this one
Part of
Southe Georgia Medical

Other organizations with this tax ID 12

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1323302400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1364428800000",
    "number": "1629346390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4280 N VALDOSTA RD",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316026814",
            "telephone_number": "229-671-2000",
            "fax_number": "229-671-2054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4280 N VALDOSTA RD",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316026814",
            "telephone_number": "229-671-2000",
            "fax_number": "229-671-2054"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOSPITAL AUTHORITY OF VALDOSTA AND LOWNDES COUNTY GEORGIA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "HOSPITAL AUTHORITY OF VALDOSTA AND LOWNDES COUNTY GEORGIA",
        "enumeration_date": "2011-12-08",
        "last_updated": "2013-03-28",
        "status": "A",
        "authorized_official_last_name": "SAULS",
        "authorized_official_first_name": "JACK",
        "authorized_official_middle_name": "RANDALL",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "229-333-1020",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Hospitalist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Smith Northview Hospitalists",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Mar 28, 2013; 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.