Active NPI
Mark Byron MD PC
- Medical Specialty Clinic/Center
- Jesup, GA
National Provider Identifier
1063607828
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Specialty Clinic/Center
- License
- 047579
- Legal business name
- MARK BYRON MD PC
- Practice address
- 162 Memorial Dr
Jesup, GA 31545-0101 - Phone
- (912) 427-8033
- NPI assigned
- Sep 13, 2007
- Last updated
- Jan 26, 2011
- Organization subpart
- Yes
- Parent organization
- MARK BYRON MD PC
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mark Daniel Byron, M.D.
- Title
- MD Owner
- Phone
- (912) 427-8033
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Specialty Clinic/Center | 261QM2500X | 047579 | GA | Primary |
Addresses
Primary practice location
162 Memorial Dr
Jesup, GA 31545-0101
Mailing address
162 Memorial Dr
Jesup, GA 31545-0101
Phone (912) 427-8033
Other names 1
- wayne urology
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA
Enrollment records 1
National Provider Directory
National Provider Directory- Part of
- Mark Byron MD PC
Locations
162 Memorial Dr
Jesup, GA 31545
Phone (912) 427-8033
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/GDGBBD
Practitioners & affiliated clinicians
Practitioners 1
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.
-
- Urology Physician
- Jesup, GA
- NPI 1154315877
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1189641600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1296000000000",
"number": "1063607828",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "162 MEMORIAL DR",
"city": "JESUP",
"state": "GA",
"postal_code": "315450101",
"telephone_number": "912-427-8033",
"fax_number": "912-427-7565"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "162 MEMORIAL DR",
"city": "JESUP",
"state": "GA",
"postal_code": "315450101",
"telephone_number": "912-427-8033"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MARK BYRON MD PC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "MARK BYRON MD PC",
"enumeration_date": "2007-09-13",
"last_updated": "2011-01-26",
"status": "A",
"authorized_official_last_name": "BYRON",
"authorized_official_first_name": "MARK",
"authorized_official_middle_name": "DANIEL",
"authorized_official_title_or_position": "MD OWNER",
"authorized_official_telephone_number": "912-427-8033",
"authorized_official_credential": "M.D."
},
"taxonomies": [
{
"code": "261QM2500X",
"taxonomy_group": "",
"desc": "Clinic/Center, Medical Specialty",
"state": "GA",
"license": "047579",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "wayne urology",
"code": "5",
"type": "Other Name"
}
]
}Other providers in Jesup, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2011; 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.