Valdosta State University Student Health Services

Primary specialty

SpecialistTaxonomy code 174400000X

Legal business name

VALDOSTA STATE UNIVERSITY STUDENT HEALTH SERVICES

Practice address

200 Georgia Avenue
Valdosta, GA 31698

Phone

(229) 333-5886

Fax

(229) 249-2791

NPI assigned

May 16, 2011

Last updated

May 16, 2011By 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

Edwin L Hiatt, MD

Title

Administrator

Phone

(229) 333-5886

Specialties & licenses 2

Addresses

Other identifiers 14

Tax ID family

Valdosta State University Student Health Services4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

• Valdosta State University

  dba VSU Student Health Center

  • Pharmacy
  • Valdosta, GA
  • NPI 1083132484
  NPD tax ID
• Valdosta State University

  • Athletic Trainer
  • Valdosta, GA
  • NPI 1578117388
  NPD tax ID
• Valdosta State University

  dba Valdosta State University Sports Medicine

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Valdosta, GA
  • NPI 1962787804
  NPD tax ID

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

{
    "created_epoch": "1305504000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1305504000000",
    "number": "1801189402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 GEORGIA AVENUE",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "31698",
            "telephone_number": "229-333-5886",
            "fax_number": "229-249-2791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 GEORGIA AVENUE",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "31698",
            "telephone_number": "229-333-5886",
            "fax_number": "229-249-2791"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VALDOSTA STATE UNIVERSITY STUDENT HEALTH SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-16",
        "last_updated": "2011-05-16",
        "status": "A",
        "authorized_official_last_name": "HIATT",
        "authorized_official_first_name": "EDWIN",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "229-333-5886",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "163WC1400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, College Health",
            "state": "GA",
            "license": null,
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "GA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IVY FRALICK RN TYPE I NPI",
            "identifier": "1447492582",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DORAINE WEBB RN TYPE I NPI",
            "identifier": "1841504156",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WILLIAM GROW MD TYPE I NPI",
            "identifier": "1730180191",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SHONTA WINBUSH MD TYPE I NPI",
            "identifier": "1093816662",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STACY REID RN TYPE I NPI",
            "identifier": "1679772419",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KIMBERLY S SNOW RN FNP TYPE I NPI",
            "identifier": "1730308883",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LEON MEEKS MD TYPE I NPI",
            "identifier": "1831194760",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEBBIE REAGAN MSN ARNP BC TYPE I NPI",
            "identifier": "1003946781",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ELSIE NAPIER RN TYPE I NPI",
            "identifier": "1720156417",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KAREN BOWSER RN TYPE I NPI",
            "identifier": "1891095840",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BARBARA PEARCE RN TYPE I NPI",
            "identifier": "1023158763",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TERESA JOHNSON RN TYPE I NPI",
            "identifier": "1841341500",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KRISTEN DUNCAN WHNP BC TYPE I NPI",
            "identifier": "1336465301",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EDWIN L HIATT MD TYPE I NPI",
            "identifier": "1699889121",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Valdosta Psychiatric Associates, LLC
• Valdosta State Prison Regional Pharmacy
• Valdosta State University (VSU Student Health Center)
• Valdosta State University
• Valdosta State University (Valdosta State University Sports Medicine)
• Valdosta Urgent Care LLC
• Valdosta Urological Associates
• Valdosta Womens Health Center PC
• Brandy R. Van Jura, FNP-C
• Shawn David Vandemark, M.D.

• Specialist in Valdosta, GA
• Providers in Valdosta, GA by specialty
• Specialist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2011; 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.