NPI age
14 years
Enumerated 2012-05-17
● Active Type 2 · Organization
Misty D. Poole, Md, Llc
Misty D. Poole, Md, Llc is 1 of 5027 internal medicine organizations in Georgia.
Primary specialty
Internal Medicine
Practice locations
1
0 secondary on file
Status
Active
No deactivations on record
Authorized official
Poole
Owner
Last NPPES update
2015-10-09
Source: monthly bulk 2026-05
How this organization compares
Across 5027 active internal medicine providers in Georgia.
NPI age
14 years
↓ 4 yr below median
Practice locations
1
0 secondary on file
Subspecialties
0
NPI lifetime · 2012 → 2026
2012-05Enumerated in NPPES
2012
2026
Where they practice
Primary practice location
210 Mose Coleman Dr
Vidalia, GA 304748677
Mailing address
210 Mose Coleman Dr
Vidalia, GA 304748677
Authorized official
Misty D Poole, MD
Owner
📞 9125372200
Individual providers at this organization
3 individual providers on file at this primary practice address.
- Daniel Dasher, MSPA, PA-C Physician Assistant NPI 1689163685
- Misty Poole, M.D. Internal Medicine NPI 1134358419
- Elisabeth Proenza, FNP-C Nurse Practitioner NPI 1619591120
Specialties
-
Internal Medicine PrimaryA 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,...
Identifiers
| Type | Value | Notes |
|---|---|---|
| 01 (GA) | 2021111317 | MEDICARE |
Other names on file (1)
Doing-business-as, former, and alternate names recorded by NPPES.
-
Vidalia Internal Medicine
Practice context
Multi-provider organization. 3 individual providers on file at this primary address.
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- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
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