Individual provider Active NPI

Briccio Dizon Valdez, M.D.

  • Psychiatry Physician
  • Columbus, GA
National Provider Identifier
1801806443
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
019353 Issued in GA
Practice address
3000 Schatulga Rd
Columbus, GA 31907-3117
Phone
(706) 568-5000
NPI assigned
Aug 8, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 019353 GA Primary

Addresses

Primary practice location

3000 Schatulga Rd
Columbus, GA 31907-3117

Mailing address

6210 Flat Rock Rd
Apt. 6148 - B
Columbus, GA 31907-9212
Phone (706) 568-5000

Other identifiers 1

IdentifierTypeStateIssuer
019353OtherGASTATE OF GA LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060911000201 GA Practitioner - Psychiatry 4385648187 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Greenleaf Center, LLC CurrentSince Jan 28, 2015 Accepting new patients
SGMP Southland LLC Psychiatry CurrentSince Jan 2, 2018 Accepting new patients
Choice Family Medicine, PC Current Accepting new patients
Georgia Pines Community Service Board CurrentSince May 7, 2013 Accepting new patients
Georgia Department of Human Resources Past Accepting new patients
Pathways Center for Behavioral and Developmental Growth Past Accepting new patients
Pathways Center for Behavioral & Developmental Growth PastSince Nov 24, 2019 Accepting new patients

Locations

116 W Thigpen Ave
Ste D
Lakeland, GA 31635
Phone (229) 482-8585

1102 Smith Ave
Ste K
Thomasville, GA 31792
Phone (912) 227-5468

1102 Smith Ave
Ste H
Thomasville, GA 31792
Phone (229) 225-5208

2217 Pineview Dr
Valdosta, GA 31602
Phone (229) 247-4357

201 Woodrow Wilson Dr
Valdosta, GA 31602
Phone (229) 241-0041

2209 Pineview Dr
Valdosta, GA 31602
Phone (229) 247-4357

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1154995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1801806443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6210 FLAT ROCK RD",
            "address_2": "APT. 6148 - B",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319079212",
            "telephone_number": "706-568-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 SCHATULGA RD",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319073117",
            "telephone_number": "706-568-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VALDEZ",
        "first_name": "BRICCIO",
        "middle_name": "DIZON",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "GA",
            "license": "019353",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF GA LICENSE",
            "identifier": "019353",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, GA

Sources for this page

Verify at the official NPI Registry.