NPIMap

Organization Active NPI

Phoebe Putney Memorial Hospital, Inc

  • Durable Medical Equipment & Medical Supplies
  • Albany, GA
National Provider Identifier
1114021847
Registry record updated Apr 24, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
License
16760 Issued in GA
Legal business name
PHOEBE PUTNEY MEMORIAL HOSPITAL, INC
Practice address
417 3Rd Ave
Albany, GA 31702-1828
Phone
(229) 312-8600
Fax
(229) 312-8624
NPI assigned
Sep 12, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2009

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

Authorized official

Name
Mr. Kerry Loudermilk
Title
Senior V.P./Chief Financial Officer
Phone
(229) 312-4068

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X 16760 GA Primary

Addresses

Primary practice location

417 3Rd Ave
Albany, GA 31702-1828

Mailing address

417 3Rd Ave
Albany, GA 31702-1828
Phone (229) 312-8600

Other identifiers 1

IdentifierTypeStateIssuer
000628592BMedicaidGA

Other names 1

  • Phoebe Orthopedic Supplies Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Phoebe Putney Memorial30 organizations share this tax ID, including this one

Other organizations with this tax ID 29

Organizations that report the same tax identification number in the National Provider Directory.

View all 29

Practitioners & affiliated clinicians

Practitioners 1

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": "1158019200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1240531200000",
    "number": "1114021847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "417 3RD AVE",
            "city": "ALBANY",
            "state": "GA",
            "postal_code": "317021828",
            "telephone_number": "229-312-8600",
            "fax_number": "229-312-8624"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "417 3RD AVE",
            "city": "ALBANY",
            "state": "GA",
            "postal_code": "317021828",
            "telephone_number": "229-312-8600",
            "fax_number": "229-312-8624"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHOEBE PUTNEY MEMORIAL HOSPITAL, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-12",
        "last_updated": "2009-04-24",
        "status": "A",
        "authorized_official_last_name": "LOUDERMILK",
        "authorized_official_first_name": "KERRY",
        "authorized_official_title_or_position": "SENIOR V.P./CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "229-312-4068",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "GA",
            "license": "16760",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000628592B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Phoebe Orthopedic Supplies",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Albany, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.