Organization Active NPI

Parrott Medical Clinic PC

  • Family Medicine Physician
  • Valdosta, GA
National Provider Identifier
1912138116
Registry record updated Aug 5, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036246 Issued in GA
Legal business name
PARROTT MEDICAL CLINIC PC
Practice address
804 Northwood Park Dr
Valdosta, GA 31602-1392
Phone
(229) 249-7888
Fax
(229) 241-7810
NPI assigned
Aug 5, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2009

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

Authorized official

Name
Dr. Jonathan R Parrott, M.D.NPI 1962470385
Title
Owner/Physician
Phone
(229) 249-7888

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
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X 036246 GA Primary

Addresses

Primary practice location

804 Northwood Park Dr
Valdosta, GA 31602-1392

Mailing address

PO Box 3225
Valdosta, GA 31604-3225
Phone (229) 249-7888

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20091002000231 GA Part B Supplier - Clinic/Group Practice 1153467238 Receives reassigned benefits from 12 practitioners
Practice locations: Valdosta, GA

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
11D1106686Parrott Medical Clinic PC804 Northwood Park Drive, Valdosta, GA 31602Certificate of waiverOct 20, 2027

National Provider Directory

National Provider Directory

Locations

804 Northwood Park Dr
Valdosta, GA 31602
Phone (229) 249-7888

Practitioners & affiliated clinicians

Practitioners 12

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.

NPI Registry JSON

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

{
    "created_epoch": "1249430400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1249430400000",
    "number": "1912138116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3225",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316043225",
            "telephone_number": "229-249-7888",
            "fax_number": "229-241-7810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "804 NORTHWOOD PARK DR",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316021392",
            "telephone_number": "229-249-7888",
            "fax_number": "229-241-7810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARROTT MEDICAL CLINIC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-08-05",
        "last_updated": "2009-08-05",
        "status": "A",
        "authorized_official_last_name": "PARROTT",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER/PHYSICIAN",
        "authorized_official_telephone_number": "229-249-7888",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "036246",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Aug 5, 2009; 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.