NPIMap

Organization Active NPI

Azalea Womens Center, PC

  • Specialist
  • Valdosta, GA
National Provider Identifier
1710194097
Registry record updated Nov 6, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
040845 Issued in GA
Legal business name
AZALEA WOMENS CENTER, PC
Practice address
2307 N Patterson St
Valdosta, GA 31602-2510
Phone
(229) 242-8888
Fax
(229) 242-0069
NPI assigned
May 17, 2007
Last updated
Nov 6, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2012

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

Authorized official

Name
Dr. John Michael Sharon, M.D.NPI 1770576860
Title
Physician
Phone
(229) 242-8888

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
Specialist 174400000X 040845 GA Primary

Addresses

Primary practice location

2307 N Patterson St
Valdosta, GA 31602-2510

Mailing address

2307 N Patterson St
Valdosta, GA 31602-2510
Phone (229) 242-8888

Other identifiers 2

IdentifierTypeStateIssuer
3948OtherGAGROUP NUMBER
300035443AMedicaidGA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040420000423 GA Part B Supplier - Clinic/Group Practice 7517952302 Receives reassigned benefits from 12 practitioners
Practice locations: Valdosta, GA

National Provider Directory

National Provider Directory

Locations

811 S Isabella St
Bldg C
Sylvester, GA 31791
Phone (229) 777-9976

2307 N Patterson St
Valdosta, GA 31602
Phone (229) 242-8888

2704 N Oak St
Bldg K
Valdosta, GA 31602
Phone (229) 219-7993

Practitioners & affiliated clinicians

Practitioners 14

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.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1179360000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1352160000000",
    "number": "1710194097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2307 N PATTERSON ST",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316022510",
            "telephone_number": "229-242-8888",
            "fax_number": "229-242-0069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2307 N PATTERSON ST",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316022510",
            "telephone_number": "229-242-8888",
            "fax_number": "229-242-0069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AZALEA WOMENS CENTER, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-17",
        "last_updated": "2012-11-06",
        "status": "A",
        "authorized_official_last_name": "SHARON",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "229-242-8888",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "GA",
            "license": "040845",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NUMBER",
            "identifier": "3948",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300035443A",
            "state": "GA"
        }
    ],
    "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 6, 2012; 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.