Individual provider Active NPI

Alice Rose House, MD

  • Family Medicine Physician
  • Macon, GA
National Provider Identifier
1043319650
Registry record updated Jul 18, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
043065 Issued in GA
Practice address
1550 College St
Suite a
Macon, GA 31207-0001
Phone
(478) 301-4111
Fax
(478) 301-5812
NPI assigned
Sep 21, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 043065 GA Primary

Addresses

Primary practice location

1550 College St
Suite a
Macon, GA 31207-0001

Mailing address

PO Box 4947
Macon, GA 31208-4947
Phone (478) 301-2362

Other identifiers 2

IdentifierTypeStateIssuer
080188724OtherGARAILROAD MEDICARE
000807364CMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080310000002 GA Practitioner - Family Practice 8426133976 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Mercer Physical Therapy CurrentSince Mar 7, 2001 Accepting new patients
Privia Medical Group of Georgia LLC Family Medicine CurrentSince Apr 30, 2024 Accepting new patients
The Corporation of Mercer University CurrentSince Mar 7, 2001 Accepting new patients
Privia Medical Group of Georgia LLC Family Medicine CurrentSince Apr 30, 2024 Accepting new patients
Mercer Medicine, LLC Family Medicine Past Accepting new patients
Central Georiga Fertility Institute Past Accepting new patients

Locations

101 Yorktown Dr
Ste 100
Fayetteville, GA 30214
Phone (770) 460-4285

1550 College St
Macon, GA 31207
Phone (478) 301-2600

1550 College St
Ste A
Macon, GA 31207

250 Mlk Blvd
Macon, GA 31201
Phone (478) 301-2362

777 Hemlock St
Macon, GA 31201
Phone (478) 474-5600

419 Elberta Rd
Warner Robins, GA 31093
Phone (478) 923-3146

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/8042/brand/1/csg/1/fhir/r4

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1158796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1405641600000",
    "number": "1043319650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4947",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312084947",
            "telephone_number": "478-301-2362",
            "fax_number": "478-301-2272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1550 COLLEGE ST",
            "address_2": "SUITE A",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312070001",
            "telephone_number": "478-301-4111",
            "fax_number": "478-301-5812"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOUSE",
        "first_name": "ALICE",
        "middle_name": "ROSE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-21",
        "last_updated": "2014-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "043065",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "080188724",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000807364C",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Macon, GA

Sources for this page

Verify at the official NPI Registry.