Peach Care LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

55077 Issued in GA

Legal business name

PEACH CARE LLC

Practice address

2383 Third St
Folkston, GA 31537-8917

Phone

(912) 496-1155

Fax

(912) 612-2011

NPI assigned

Aug 7, 2014

Last updated

Sep 18, 2025By 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

Maged E Abdelmalik, MDNPI 1770558470

Title

Ceo

Phone

(912) 496-1155

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Practitioners 5

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.

• Maged Edward Abdelmalik, M.D.

  • Internal Medicine Physician
  • Folkston, GA
  • NPI 1770558470
  Medicare reassignment NPD Authorized official
• Betsy Erin Tanner, MSN-FNP, BC

  • Nurse Practitioner
  • Waycross, GA
  • NPI 1295387751
  Medicare reassignment NPD
• Angela Dawn Johnson, APRN

  • Family Nurse Practitioner
  • Folkston, GA
  • NPI 1487858650
  NPD (past)
• Albert Marion Thompson Jr., MD

  • Family Medicine Physician
  • Folkston, GA
  • NPI 1922018159
  NPD (past)
• Amanda Lee West, APRN

  • Family Nurse Practitioner
  • Hilliard, FL
  • NPI 1063706026
  NPD (past)

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

{
    "created_epoch": "1407369600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1758153600000",
    "number": "1730598491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2383 THIRD ST",
            "city": "FOLKSTON",
            "state": "GA",
            "postal_code": "315378917",
            "telephone_number": "912-496-1155",
            "fax_number": "912-612-2011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2383 THIRD ST",
            "city": "FOLKSTON",
            "state": "GA",
            "postal_code": "315378917",
            "telephone_number": "912-496-1155",
            "fax_number": "912-612-2011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEACH CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-08-07",
        "last_updated": "2025-09-18",
        "certification_date": "2025-09-18",
        "status": "A",
        "authorized_official_last_name": "ABDELMALIK",
        "authorized_official_first_name": "MAGED",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "912-496-1155",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "55077",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• McKinney Medical Center, Inc.
• Brianna Nettles, FNP-BC
• Ginia Patrice O'Steen-Johnson, LPTA, BS,MBA
• Avonda Paul, OCCUPATIONAL THERAPY
• Danielle Pautler
• Heather G Peebles, LD
• Ghislain Richard Perron, MD
• Richard David Ricks, PTA
• Sarah Suzanne Ridgeway, APRN
• Brandi Robertson

• Internal Medicine Physician in Folkston, GA
• Providers in Folkston, GA by specialty
• Internal Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2025; 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.