{"npi":"1538200035","type":"NPI-2","status":"active","name":{"display":"Valdosta Medical Clinic","other":[],"organization_name":"VALDOSTA MEDICAL CLINIC","authorised_official":"Robin Bush"},"specialty":{"primary_taxonomy":"261QM1300X","primary_taxonomy_description":"Multi-Specialty Clinic/Center","slug":"multi-specialty-clinic-center","schema_org_specialty":null,"all":[{"code":"261QM1300X","description":"Multi-Specialty Clinic/Center","primary":true,"state":null,"license":null}]},"addresses":[{"purpose":"LOCATION","street_1":"3207 COUNTRY CLUB DR","city":"VALDOSTA","state":"GA","postal_code":"316051029","country_code":"US","phone":"2292428480","fax":"2292410252"},{"purpose":"MAILING","street_1":"3207 COUNTRY CLUB DR.","city":"VALDOSTA","state":"GA","postal_code":"31605","country_code":"US","phone":"2292428480","fax":"2292420070"}],"license":null,"identifiers":[],"pecos":{"enrolled_at":"2026-05-09T10:41:39.028268+00:00","enrollments":[{"enrlmt_id":"O20041222000501","type_code":"12-70","type_desc":"PART B SUPPLIER - CLINIC/GROUP PRACTICE","state":"GA","pac_id":"9234197286"}]},"enumeration_date":"2007-02-09","last_updated":"2015-01-29","_meta":{"source":"NPPES","snapshot_date":"2015-01-29","doc_url":"https://findmynpi.com/api"}}