VIDALIA INTERNAL MEDICINE
NPI 1003176546
Internal Medicine in Vidalia, GA

Active since May 17, 2012
210 MOSE COLEMAN DR, VIDALIA, GA 30474(912) 537-2200(912) 537-2260 Get Directions Write a Review

NPPES record last updated: October 9, 2015. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Vidalia Internal Medicine NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

VIDALIA INTERNAL MEDICINE (NPI 1003176546) is a healthcare organization registered as an internal medicine in Vidalia, Georgia and active in the NPI registry since May 2012. The organization lists Misty D Poole, Owner, as its authorized official.

NPPES Registry Identity

NPI1003176546
Entity TypeOrganization
Primary Taxonomy207R00000X
Legal Business NameMISTY D. POOLE, MD, LLC
Location Address210 MOSE COLEMAN DRVidalia, GA 30474-8677
Mailing Address210 Mose Coleman DrVidalia, GA 30474-8677 · (912) 537-2200 · Fax (912) 537-2260
Fax(912) 537-2260
Organization SubpartNo
Authorized OfficialMisty D PooleOwner · (912) 537-2200
Enumeration DateMay 17, 2012
Last NPPES UpdateOctober 9, 2015
NPI 1003176546 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
Definition

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

210 MOSE COLEMAN DR, Vidalia, GA 30474

Other Names 1

Doing Business AsVidalia Internal Medicine

Other Identifiers 1

Other2021111317GA · Medicare

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 11D2044574

Misty D Poole, MD, LLC · Vidalia, GA
Expired · Jul 25, 2026
CLIA Number11D2044574
Laboratory TypePhysician Office
Certificate Effective DateJuly 26, 2024
Certificate Expiration DateJuly 25, 2026
Laboratory DirectorDr. Misty D. Poole
Laboratory Phone(912) 537-2200
Laboratory LocationMisty D Poole, MD, LLC210 Mose Coleman Drive, Vidalia, GA 30474
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Internal Medicine
210 MOSE COLEMAN DR
VIDALIA, GA 30474
Physician Assistant (Medical)
210 MOSE COLEMAN DR
VIDALIA, GA 30474
Nurse Practitioner (Family)
210 MOSE COLEMAN DR
VIDALIA, GA 30474

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Misty D. Poole, MD, LLC's NPI number?

The NPI number for Misty D. Poole, MD, LLC is 1003176546. It was assigned to this organization in the NPPES registry on May 17, 2012.

Where is Misty D. Poole, MD, LLC located?

Misty D. Poole, MD, LLC is located at 210 Mose Coleman Dr, Vidalia, GA 30474. The listed phone number is (912) 537-2200.

What is Misty D. Poole, MD, LLC's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

What insurance does Misty D. Poole, MD, LLC accept?

Health plans from Ambetter Health, Ambetter from Absolute Total Care, Ambetter of Alabama, Ambetter of North Carolina and Ambetter of Tennessee list Misty D. Poole, MD, LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Misty D. Poole, MD, LLC was last updated on October 9, 2015. NPI Profile syncs with the weekly NPPES data releases published by CMS.