Parkway Family Medicine LLC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

RN064864 Issued in GA

Legal business name

PARKWAY FAMILY MEDICINE LLC

Practice address

122 Canal St Ste 102
Pooler, GA 31322-4408

Phone

(912) 450-0999

Fax

(912) 450-0999

NPI assigned

Feb 14, 2011

Last updated

Aug 3, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ludella Brown, APN, DNPNPI 1700999760

Title

Advanced Practice Nurse

Phone

(912) 450-0999

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Womens Healthcare and Family Medicine Former legal business name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 3

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.

• Ludella Brown, APRN NP-C

  • Adult Health Nurse Practitioner
  • Pooler, GA
  • NPI 1700999760
  Medicare reassignment Authorized official
• Jacqueline Ann Brown, FNP

  • Family Nurse Practitioner
  • Pooler, GA
  • NPI 1942578737
  Medicare reassignment NPD
• Kelli Marie Thompson

  • Family Nurse Practitioner
  • Pooler, GA
  • NPI 1760004667
  NPD

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

{
    "created_epoch": "1297641600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1691020800000",
    "number": "1730486598",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "122 CANAL ST STE 102",
            "city": "POOLER",
            "state": "GA",
            "postal_code": "313224408",
            "telephone_number": "912-450-0999",
            "fax_number": "912-450-0999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "122 CANAL ST STE 102",
            "city": "POOLER",
            "state": "GA",
            "postal_code": "313224408",
            "telephone_number": "912-450-0999",
            "fax_number": "912-450-0999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARKWAY FAMILY MEDICINE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-02-14",
        "last_updated": "2023-08-03",
        "certification_date": "2023-08-03",
        "status": "A",
        "authorized_official_last_name": "BROWN",
        "authorized_official_first_name": "LUDELLA",
        "authorized_official_title_or_position": "ADVANCED PRACTICE NURSE",
        "authorized_official_telephone_number": "912-450-0999",
        "authorized_official_credential": "APN, DNP"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "GA",
            "license": "RN064864",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "153640219H",
            "state": "GA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Pooler",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Pooler",
            "address_1": "122 Canal St Ste 104",
            "city": "Pooler",
            "state": "GA",
            "country_code": "US",
            "postal_code": "313224408",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Womens Healthcare and Family Medicine",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Womens Healthcare and Family Medicine",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Makayla Page
• Andrew B Pandya, MD
• Julianna Murphy Parish, PHARMD
• Jaelyn Parker
• Jania Parker
• Tamala D Parsons, CRNA
• Dhirenkumar Patel
• Dhruminkumar Patel
• Dimple Jayantilal Patel, DMD
• Krupali Patel, RPH

• Primary Care Clinic/Center in Pooler, GA
• Providers in Pooler, GA by specialty
• Primary Care Clinic/Center in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.