David K. Vickers

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

RN164513 Issued in GA

Practice address

103 James St
Adel, GA 31620-1504

Phone

(229) 896-3424

Fax

(229) 896-3838

NPI assigned

Mar 3, 2017

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA, AL2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Nurse Practitioner

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Donalsonville Hospital IncGroup PAC ID 7113919820, 63 clinicians

Southland Consolidated Emergency Services LLCGroup PAC ID 2860792066, 68 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Memorial Hospital and Manor Hospital, Bainbridge, GA, CCN 110132
• Donalsonville Hospital Inc Hospital, Donalsonville, GA, CCN 110194

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Donalsonville Hospital Inc

  • Rural Acute Care Hospital
  • Donalsonville, GA
  • NPI 1720095805
  Medicare reassignment Care Compare group NPD
• Southland Consolidated Emergency Services, LLC

  • Emergency Medicine Physician
  • Elberton, GA
  • NPI 1174917124
  Medicare reassignment Care Compare group NPD
• Southland Behavioral Health Services LLC

  • Hospitalist Physician
  • Valdosta, GA
  • NPI 1619505765

  AL

  Medicare reassignment NPD
• Southland Emergency Medical Services, L.L.C

  • Emergency Medicine Physician
  • Thomasville, GA
  • NPI 1477701472
  Medicare reassignment NPD
• Tift Regional Health System Inc

  • Ophthalmology Physician
  • Tifton, GA
  • NPI 1790280857
  NPD
• Hospital Authority of the City of Bainbridge and Decatur County

  • Multi-Specialty Clinic/Center
  • Bainbridge, GA
  • NPI 1053388256
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Donalsonville Hospital Inc

  • Rural Acute Care Hospital
  • Donalsonville, GA
  • NPI 1720095805
  Care Compare affiliation
• Hospital Authority of the City of Bainbridge and Decatur County

  • Multi-Specialty Clinic/Center
  • Bainbridge, GA
  • NPI 1053388256

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1488499200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1488499200000",
    "number": "1629518014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "907 18TH ST E",
            "address_2": "SUITE 150",
            "city": "TIFTON",
            "state": "GA",
            "postal_code": "317943643",
            "telephone_number": "229-353-3450",
            "fax_number": "229-353-6060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 JAMES ST",
            "city": "ADEL",
            "state": "GA",
            "postal_code": "316201504",
            "telephone_number": "229-896-3424",
            "fax_number": "229-896-3838"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VICKERS",
        "first_name": "DAVID",
        "middle_name": "K.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-03-03",
        "last_updated": "2017-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN164513",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amanda Hope Tillman, LMFT
• Tanya Tim
• Tonyia Wilson
• Jasmine Tucker, MSW, LCSW
• Vincent Valencia, M.D.
• Carli Vining, ATC, LAT
• Wal-Mart Stores East LP
• Wal-Mart Stores East, LP
• Walgreen Co
• Alexander Warren, FNP-C

• Family Nurse Practitioner in Adel, GA
• Providers in Adel, GA by specialty
• Family Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.