NPIMap

Organization Active NPI

Ben Hill Emergency Group LLC

  • Emergency Medicine Physician
  • Fitzgerald, GA
National Provider Identifier
1043328156
Registry record updated Feb 16, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
Legal business name
BEN HILL EMERGENCY GROUP LLC
Practice address
200 Perry House Rd
Fitzgerald, GA 31750-8857
Phone
(800) 893-9698
NPI assigned
Aug 28, 2006
Last updated
Feb 16, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2016

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

Authorized official

Name
Lisha C Falk
Title
VP of Contracting
Phone
(800) 893-9698

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207P00000X Primary
Medical Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363AM0700X
Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363L00000X

Addresses

Primary practice location

200 Perry House Rd
Fitzgerald, GA 31750-8857

Mailing address

200 Corporate Blvd
Lafayette, LA 70508-3870
Phone (800) 893-9896

Other names 1

  • DORMINY MEDICAL CENTER Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20061025000232 GA Part B Supplier - Clinic/Group Practice 3274530837 Receives reassigned benefits from 23 practitioners
Practice locations: Fitzgerald, GA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 24

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.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1156723200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1455580800000",
    "number": "1043328156",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 CORPORATE BLVD",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705083870",
            "telephone_number": "800-893-9896"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 PERRY HOUSE RD",
            "city": "FITZGERALD",
            "state": "GA",
            "postal_code": "317508857",
            "telephone_number": "800-893-9698"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEN HILL EMERGENCY GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-28",
        "last_updated": "2016-02-16",
        "status": "A",
        "authorized_official_last_name": "FALK",
        "authorized_official_first_name": "LISHA",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "VP OF CONTRACTING",
        "authorized_official_telephone_number": "800-893-9698"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Emergency Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DORMINY MEDICAL CENTER",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Fitzgerald, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2016; 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.