Organization Active NPI

Lentz Urgent Care & Family Med, Inc

  • Family Medicine Physician
  • Jesup, GA
National Provider Identifier
1003449968
Registry record updated Aug 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
LENTZ URGENT CARE & FAMILY MED, INC
Practice address
182 Sunset Blvd
Jesup, GA 31545-0401
Phone
(912) 385-2102
Fax
(912) 385-2180
NPI assigned
Feb 19, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2023

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

Authorized official

Name
Randy Lentz, MDNPI 1205832227
Title
Owner/Doctor
Phone
(912) 385-2102

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 Primary

Addresses

Primary practice location

182 Sunset Blvd
Jesup, GA 31545-0401

Mailing address

182 Sunset Blvd
Jesup, GA 31545-0401
Phone (912) 385-2102

Other identifiers 1

IdentifierTypeStateIssuer
1205832227MedicaidGA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200508001765 GA Part B Supplier - Clinic/Group Practice 4587095476 Receives reassigned benefits from 1 practitioner
Practice locations: Jesup, GA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1582070400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1693440000000",
    "number": "1003449968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "182 SUNSET BLVD",
            "city": "JESUP",
            "state": "GA",
            "postal_code": "315450401",
            "telephone_number": "912-385-2102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "182 SUNSET BLVD",
            "city": "JESUP",
            "state": "GA",
            "postal_code": "315450401",
            "telephone_number": "912-385-2102",
            "fax_number": "912-385-2180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LENTZ URGENT CARE & FAMILY MED, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-19",
        "last_updated": "2023-08-31",
        "certification_date": "2023-08-31",
        "status": "A",
        "authorized_official_last_name": "LENTZ",
        "authorized_official_first_name": "RANDY",
        "authorized_official_title_or_position": "OWNER/DOCTOR",
        "authorized_official_telephone_number": "912-385-2102",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1205832227",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jesup, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.