NPIMap

Organization Active NPI

Macon GYN/OB Associates

  • Specialist
  • Macon, GA
National Provider Identifier
1073629630
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
MACON GYN/OB ASSOCIATES
Practice address
650 Coliseum PL
Macon, GA 31217-3867
Phone
(478) 745-7935
Fax
(478) 745-7806
NPI assigned
Aug 23, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
A T Coppage
Title
President
Phone
(478) 745-7935

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X GA Primary

Addresses

Primary practice location

650 Coliseum PL
Macon, GA 31217-3867

Mailing address

650 Coliseum PL
Macon, GA 31217-3867
Phone (478) 745-7935

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040430000565 GA Part B Supplier - Clinic/Group Practice 0244227189 Receives reassigned benefits from 4 practitioners
Practice locations: Macon, GA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

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

NPI Registry JSON

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

{
    "created_epoch": "1156291200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1073629630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "650 COLISEUM PL",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312173867",
            "telephone_number": "478-745-7935",
            "fax_number": "478-745-7806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "650 COLISEUM PL",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312173867",
            "telephone_number": "478-745-7935",
            "fax_number": "478-745-7806"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MACON GYN/OB ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-23",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "COPPAGE",
        "authorized_official_first_name": "A",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "478-745-7935"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "GA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Jul 21, 2022; 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.