SOUTHWELL PEDIATRICS VALDOSTA
NPI 1962035360
Pediatrics in Valdosta, GA

Q: What is Southwell Ambulatory Inc's NPI number?

The NPI number for Southwell Ambulatory Inc is 1962035360. It was assigned to this organization in the NPPES registry on February 14, 2020. The provider is doing business as Southwell Pediatrics Valdosta.

Q: What is Southwell Ambulatory Inc's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Active since February 14, 2020

3014 N PATTERSON ST, VALDOSTA, GA 31602(229) 242-0194(229) 242-1785 Get Directions Write a Review

NPPES record last updated: October 18, 2022. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Oct 18, 2022, Feb 14, 2020 (2 updates tracked since 2020).

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About Southwell Pediatrics Valdosta NPPES

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

SOUTHWELL PEDIATRICS VALDOSTA (NPI 1962035360) is a healthcare organization registered as a pediatrics in Valdosta, Georgia and active in the NPI registry since February 2020. The organization lists Troy Brooks, Svp/cfo, as its authorized official.

NPPES Registry Identity

NPI1962035360

Entity TypeOrganization

Primary Taxonomy208000000X

Legal Business NameSOUTHWELL AMBULATORY INC

Location Address3014 N PATTERSON STValdosta, GA 31602-1711

Mailing Address907 18th St E Ste 400Tifton, GA 31794-3684 · (229) 353-3422

Phone(229) 242-0194

Fax(229) 242-1785

Organization SubpartNo

Authorized OfficialTroy BrooksSvp/cfo · (229) 353-3397

Enumeration DateFebruary 14, 2020

Last NPPES UpdateOctober 18, 20222 updates tracked since enumeration

NPPES CertifiedOctober 18, 2022

✔ NPI 1962035360 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians

Taxonomy Code208000000X

Definition

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

3014 N PATTERSON ST, Valdosta, GA 31602

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Other Names 1

Doing Business AsSouthwell Pediatrics Valdosta

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

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Southwell Pediatrics Valdosta is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 16 clinicians reassign Medicare billing to Southwell Pediatrics Valdosta, which bills Medicare for the services they deliver. Of these, 2 practice at this address and 13 within 10 miles. They are listed nearest first.

Clinicians by Medicare Specialty 5

Certified Nurse Midwife (CNM)4

Nurse Practitioner4

Gastroenterology3

Obstetrics/Gynecology3

Internal Medicine2

Clinicians, nearest first (16)

Bryson Simpson, FNP-C

Nurse Practitioner

NPI 1104792704

3014 N PATTERSON ST
Valdosta, GA 31602

(229) 262-6815

✔ PECOS✔ Accepts MedicareSame address

Joseph Thomas, MD

Internal Medicine

NPI 1437258506

3014 N PATTERSON ST
Valdosta, GA 31602

(229) 262-6815

✔ PECOS✔ Accepts MedicareSame address

Nancy Roe, FNP-C

Nurse Practitioner

NPI 1124680673

2922 N OAK ST STE C
Valdosta, GA 31602

(229) 244-1570

✔ PECOS✔ Accepts Medicare0.2 mi

Kenneth Kiser, APRN

Nurse Practitioner

NPI 1609230069

2922 N OAK ST STE C
Valdosta, GA 31602

(229) 262-6819

✔ PECOS✔ Accepts Medicare0.2 mi

Lynn Lee, M.D.

Internal Medicine

NPI 1548298839

410 CONNELL RD
Valdosta, GA 31602

(229) 244-4720

✔ PECOS0.3 mi

Eric Ward, M.D.

Gastroenterology

NPI 1699703041

410 CONNELL RD
Valdosta, GA 31602

(229) 244-1570

✔ PECOS✔ Accepts Medicare0.3 mi

Kathryn Watt, NPC

Nurse Practitioner

NPI 1154446862

410 CONNELL RD
Valdosta, GA 31602

(229) 244-4720

✔ PECOS✔ Accepts Medicare0.3 mi

Joe Clifton, MD

Obstetrics/Gynecology

NPI 1255417994

220 NORTHSIDE DRIVE
Valdosta, GA 31602

(229) 241-2800

✔ PECOS✔ Accepts Medicare0.4 mi

Sara Yarbrough, DO

Obstetrics/Gynecology

NPI 1437235199

220 NORTHSIDE DRIVE
Valdosta, GA 31602

(229) 241-2800

✔ PECOS✔ Accepts Medicare0.4 mi

Michelle Shifflett, CNM

Certified Nurse Midwife (CNM)

NPI 1073034732

814 NORTHWOOD PARK DR
Valdosta, GA 31602

(229) 262-6810

✔ PECOS✔ Accepts Medicare1.0 mi

Heather Stroh, CNM

Certified Nurse Midwife (CNM)

NPI 1710965843

814 NORTHWOOD PARK DR
Valdosta, GA 31602

(229) 262-6819

✔ PECOS✔ Accepts Medicare1.0 mi

Pamela Temples, MD

Obstetrics/Gynecology

NPI 1740366442

814 NORTHWOOD PARK DR
Valdosta, GA 31602

(229) 262-6810

✔ PECOS✔ Accepts Medicare1.0 mi

Edward Fricker, MD

Gastroenterology

NPI 1316933823

3207 COUNTRY CLUB DR
Valdosta, GA 31605

(229) 242-8480

✔ PECOS✔ Accepts Medicare1.1 mi

Karen Honn, CNM

Certified Nurse Midwife (CNM)

NPI 1710317094

1301 HODGES DR
Tallahassee, FL 32308

(850) 431-5430

✔ PECOS64 mi

Hillary Midler, MSN-MIDWIFERY

Certified Nurse Midwife (CNM)

NPI 1750895082

1301 HODGES DR
Tallahassee, FL 32308

(850) 431-5430

✔ PECOS64 mi

Carl Woods, M.D.

Gastroenterology

NPI 1174550727

801 E 6TH ST STE 501
Panama City, FL 32401

(850) 804-3040

✔ PECOS✔ Accepts Medicare149 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 Southwell Ambulatory Inc's NPI number?

The NPI number for Southwell Ambulatory Inc is 1962035360. It was assigned to this organization in the NPPES registry on February 14, 2020. The provider is doing business as Southwell Pediatrics Valdosta.

Where is Southwell Ambulatory Inc located?

Southwell Ambulatory Inc is located at 3014 N Patterson St, Valdosta, GA 31602. The listed phone number is (229) 242-0194.

What is Southwell Ambulatory Inc's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Is Southwell Ambulatory Inc enrolled in Medicare?

Yes. Southwell Ambulatory Inc is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Southwell Ambulatory Inc?

According to the CMS Revalidation Reassignment List (October 2026 release), 16 clinicians in 5 Medicare specialties reassign their Medicare billing to Southwell Ambulatory Inc. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Certified Nurse Midwife (CNM) (4), Nurse Practitioner (4) and Gastroenterology (3). Of these, 2 practice at this address and 13 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Southwell Ambulatory Inc was last updated on October 18, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.