Active NPI
James Womack, PA-C
- Physician Assistant
- Newton, GA
National Provider Identifier
1003918376
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 1172
- Practice address
- 327-3 Sunset Avenue SW
Newton, GA 39870 - Phone
- (229) 734-5250
- Fax
- (229) 734-5606
- NPI assigned
- Sep 5, 2006
- Last updated
- Nov 29, 2011
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 1172 | GA | Primary |
Addresses
Primary practice location
327-3 Sunset Avenue SW
Newton, GA 39870
Mailing address
204 N Westover Blvd
Albany, GA 31707-2983
Phone (229) 888-6559
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1000000240A | Medicaid | GA | |
| 7011046 | Other | GA | AETNA |
| 970001400 | Other | GA | RR MCARE - BCPHC |
Other names 1
- Jim Womacl
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1172 | GA | MD | Physical Therapy Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Albany Area Primary Health Care, Inc. | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Baker County Primary Health Care
- Federally Qualified Health Center (FQHC)
- Newton, GA
- NPI 1184649329
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1157414400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1322524800000",
"number": "1003918376",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "204 N WESTOVER BLVD",
"city": "ALBANY",
"state": "GA",
"postal_code": "317072983",
"telephone_number": "229-888-6559",
"fax_number": "229-436-4107"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "327-3 SUNSET AVENUE SW",
"city": "NEWTON",
"state": "GA",
"postal_code": "39870",
"telephone_number": "229-734-5250",
"fax_number": "229-734-5606"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WOMACK",
"first_name": "JAMES",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-05",
"last_updated": "2011-11-29",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "GA",
"license": "1172",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1000000240A",
"state": "GA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "7011046",
"state": "GA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MCARE - BCPHC",
"identifier": "970001400",
"state": "GA"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "JIM",
"last_name": "WOMACL",
"credential": "PA-C",
"code": "5",
"type": "Other Name"
}
]
}Other providers in Newton, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.