NPIMap

Organization Active NPI

Vidalia Children'S Center LLC

  • Pediatrics Physician
  • Vidalia, GA
National Provider Identifier
1679705115
Registry record updated Sep 5, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
VIDALIA CHILDREN'S CENTER LLC
Practice address
125 Church Street
Vidalia, GA 30474
Phone
(912) 538-8484
Fax
(912) 538-8665
NPI assigned
Aug 18, 2009
Organization subpart
Yes
Parent organization
SOUTHEADT REGIONAL PRIMARY CARE CORPORATIONAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 5, 2014

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

Authorized official

Name
Tony M Osteen, CFO
Title
Cfo
Phone
(912) 538-5314

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X Primary

Addresses

Primary practice location

125 Church Street
Vidalia, GA 30474

Mailing address

PO Box 407
Vidalia, GA 30475-0407
Phone (912) 538-8484

National Provider Directory

National Provider Directory
Part of
Southeast Regional Primary Care Corporation

Interoperability endpoints

  • Direct secure messaging: craig.horton@vcc.gadirect.net
  • Direct secure messaging: chelsea.tehan@vcc.gadirect.net
  • Direct secure messaging: caryn.mastermansmith@vcc.gadirect.net
  • Direct secure messaging: eseovhe.egborge@vcc.gadirect.net
  • Direct secure messaging: memori.mccarley@vcc.gadirect.net
  • Direct secure messaging: courtney.ragan@vcc.gadirect.net

Practitioners & affiliated clinicians

Practitioners 6

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

NPI Registry JSON

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

{
    "created_epoch": "1250553600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1409875200000",
    "number": "1679705115",
    "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": "912-538-8484",
            "fax_number": "912-538-8665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 CHURCH STREET",
            "city": "VIDALIA",
            "state": "GA",
            "postal_code": "30474",
            "telephone_number": "912-538-8484",
            "fax_number": "912-538-8665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VIDALIA CHILDREN'S CENTER LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SOUTHEADT REGIONAL PRIMARY CARE CORPORATION",
        "enumeration_date": "2009-08-18",
        "last_updated": "2014-09-05",
        "status": "A",
        "authorized_official_last_name": "OSTEEN",
        "authorized_official_first_name": "TONY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "912-538-5314",
        "authorized_official_credential": "CFO"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vidalia, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.