Physician Consultants of Georgia Warner Robins LLC

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

Legal business name

PHYSICIAN CONSULTANTS OF GEORGIA WARNER ROBINS LLC

Doing business as

Warner Robins Vascular Center

Practice address

1570 Watson Blvd
Warner Robins, GA 31093-3474

Phone

(478) 250-1325

Fax

(478) 254-6860

NPI assigned

Oct 2, 2020

Organization subpart

No

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

Authorized official

Name

Brianna Goodie, RN

Title

Clinical Manager

Phone

(478) 972-4467

Specialties & licenses 1

Addresses

Other names 1

• Warner Robins Vascular Center Doing business as

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Practitioners 5

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

• Reuben Kristian Ellis, M.D.

  • Nephrology Physician
  • Macon, GA
  • NPI 1114969110
  Medicare reassignment NPD
• Madalyn N Davidoff, M.D.

  • Cardiovascular Disease Physician
  • Warner Robins, GA
  • NPI 1912909201
  NPD (past)
• Melissa Kirkland Payne, NP-C

  • Family Nurse Practitioner
  • Warner Robins, GA
  • NPI 1518162007
  NPD (past)
• Velisar L Rill, M.D.

  • Interventional Cardiology Physician
  • Reno, NV
  • NPI 1659363141
  NPD (past)
• Olexandr V. Smolensky, M.D.

  • Cardiovascular Disease Physician
  • Milwaukee, WI
  • NPI 1962650440
  NPD (past)

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

{
    "created_epoch": "1601596800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1601596800000",
    "number": "1033716139",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6612",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312086612",
            "telephone_number": "478-250-1325",
            "fax_number": "478-254-6860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1570 WATSON BLVD",
            "city": "WARNER ROBINS",
            "state": "GA",
            "postal_code": "310933474",
            "telephone_number": "478-250-1325",
            "fax_number": "478-254-6860"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSICIAN CONSULTANTS OF GEORGIA WARNER ROBINS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-02",
        "last_updated": "2020-10-02",
        "certification_date": "2020-10-02",
        "status": "A",
        "authorized_official_last_name": "GOODIE",
        "authorized_official_first_name": "BRIANNA",
        "authorized_official_title_or_position": "CLINICAL MANAGER",
        "authorized_official_telephone_number": "478-972-4467",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "accounts@pcgneph.com",
            "affiliation": "N",
            "endpointDescription": "email address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1570 Watson Blvd",
            "city": "Warner Robins",
            "state": "GA",
            "country_code": "US",
            "postal_code": "310933474",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Warner Robins Vascular Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Phoenix Center Behavioral Health Services
• Phoenix Center Community Service Board (Phoenix Center BHS)
• Phoenix Center Community Service Board (Phoenix Center BHS)
• Phoenix Center Community Service Board (Phoenix Center BHS)
• Phoenix Health Center
• Physician Disability Examination Services Inc (Dania Beach West Medicine and Rehab)
• Physicians for Women, PC
• Physio Lab Physical Therapy
• Allison Pierce, PHARMD
• April E Pierce, CFNP

• Nephrology Physician in Warner Robins, GA
• Providers in Warner Robins, GA by specialty
• Nephrology Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2020; 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.