Organization Active NPI

Heart of Georgia Rheumatology LLC

  • Rheumatology Physician
  • Macon, GA
National Provider Identifier
1013312040
Registry record updated Mar 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rheumatology PhysicianTaxonomy code 207RR0500X
License
052700 Issued in GA
Legal business name
HEART OF GEORGIA RHEUMATOLOGY LLC
Practice address
1508 Hardeman Ave Ste a
Macon, GA 31201-1471
Phone
(478) 742-3704
Fax
(478) 738-8609
NPI assigned
Nov 4, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2020

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

Authorized official

Name
Dr. Nannette R Crowley, MDNPI 1902841307
Title
Founding Member
Phone
(478) 742-3704

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
Rheumatology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RR0500X 052700 GA Primary

Addresses

Primary practice location

1508 Hardeman Ave Ste a
Macon, GA 31201-1471

Mailing address

1508 Hardeman Ave Ste a
Macon, GA 31201-1471
Phone (478) 742-3704

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150501001276 GA Part B Supplier - Clinic/Group Practice 7113246760 Receives reassigned benefits from 4 practitioners
Practice locations: Macon, GA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
11D2092354Heart of Georgia Rheumatology, LLC1508 Hardeman Avenue, Suite a, Macon, GA 31201Certificate of waiverMar 2, 2027

National Provider Directory

National Provider Directory

Locations

1508 Hardeman Ave
Ste A
Macon, GA 31201
Phone (478) 742-3704

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/CICBAA

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1415059200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1583193600000",
    "number": "1013312040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1508 HARDEMAN AVE STE A",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312011471",
            "telephone_number": "478-742-3704",
            "fax_number": "478-738-8609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1508 HARDEMAN AVE STE A",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312011471",
            "telephone_number": "478-742-3704",
            "fax_number": "478-738-8609"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEART OF GEORGIA RHEUMATOLOGY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-11-04",
        "last_updated": "2020-03-03",
        "certification_date": "2020-03-03",
        "status": "A",
        "authorized_official_last_name": "CROWLEY",
        "authorized_official_first_name": "NANNETTE",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "FOUNDING MEMBER",
        "authorized_official_telephone_number": "478-742-3704",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RR0500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Rheumatology",
            "state": "GA",
            "license": "052700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Macon, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.