NPIMap

Organization Active NPI

Cogent Healthcare of Macon, LLC

  • Internal Medicine Physician
  • Macon, GA
National Provider Identifier
1073564217
Registry record updated Dec 19, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
COGENT HEALTHCARE OF MACON, LLC
Practice address
777 Hemlock St
Macon, GA 31201-2102
Phone
(478) 633-7550
Fax
(478) 633-3235
NPI assigned
May 12, 2006
Last updated
Dec 19, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2016

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

Authorized official

Name
Melissa Simonton Land
Title
Manager
Phone
(478) 475-1299

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X NU
Nurse Practitioner 363L00000X NU
Family Medicine Physician 207Q00000X NU
Internal Medicine Physician 207R00000X NU Primary
Hospitalist Physician 208M00000X NU

Addresses

Primary practice location

777 Hemlock St
Macon, GA 31201-2102

Mailing address

PO Box 26040
Macon, GA 31221-6040
Phone (478) 475-1299

Other identifiers 1

IdentifierTypeStateIssuer
260348606AMedicaidGA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040826000927 GA Part B Supplier - Clinic/Group Practice 9234104019 Receives reassigned benefits from 111 practitioners
Practice locations: Byron, GA; Macon, GA; Milledgeville, GA; Perry, GA

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

777 Hemlock St
#104
Macon, GA 31201
Phone (478) 633-7550

Practitioners & affiliated clinicians

Practitioners 111

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 111

NPI Registry JSON

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

{
    "created_epoch": "1147392000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1482105600000",
    "number": "1073564217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 26040",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312216040",
            "telephone_number": "478-475-1299",
            "fax_number": "478-405-7928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 HEMLOCK ST",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312012102",
            "telephone_number": "478-633-7550",
            "fax_number": "478-633-3235"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COGENT HEALTHCARE OF MACON, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-12",
        "last_updated": "2016-12-19",
        "status": "A",
        "authorized_official_last_name": "LAND",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_middle_name": "SIMONTON",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "478-475-1299"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "260348606A",
            "state": "GA"
        }
    ],
    "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 Dec 19, 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.