NPIMap

Organization Active NPI

Phoebe Infectious Disease

  • Clinic/Center
  • Albany, GA
National Provider Identifier
1114220852
Registry record updated Dec 20, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
PHOEBE INFECTIOUS DISEASE
Practice address
507 W 3Rd Ave
Ste 3
Albany, GA 31701-1958
Phone
(229) 312-5800
Fax
(229) 312-5853
NPI assigned
Dec 20, 2010
Last updated
Dec 20, 2010By the provider in NPPES
Organization subpart
Yes
Parent organization
PHOEBE PHYSICIAN GROUP INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 20, 2010

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

Authorized official

Name
Robert Lagesse
Title
Sr VP Physician Practices
Phone
(229) 312-1000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X NU Primary

Addresses

Primary practice location

507 W 3Rd Ave
Ste 3
Albany, GA 31701-1958

Mailing address

507 W 3Rd Ave
Ste 3
Albany, GA 31701-1958
Phone (229) 312-5800

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090121000583 GA Part B Supplier - Clinic/Group Practice 8426112350 Receives reassigned benefits from 1,136 practitioners
14 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment

Other NPIs on the same Medicare enrollment 14

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 14

National Provider Directory

National Provider Directory
Tax ID family
Phoebe Family Medicinecoffee County26 organizations share this tax ID, including this one
Part of
Phoebe Family Medicinecoffee County

Other organizations with this tax ID 25

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

View all 25

Locations

2002 Palmyra Rd
Ste 101
Albany, GA 31701
Phone (229) 432-1440

415 E 4th Ave
Ste C
Cordele, GA 31015
Phone (229) 273-7443

Practitioners & affiliated clinicians

Practitioners 55

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 55

NPI Registry JSON

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

{
    "created_epoch": "1292803200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1292803200000",
    "number": "1114220852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "507 W 3RD AVE",
            "address_2": "STE 3",
            "city": "ALBANY",
            "state": "GA",
            "postal_code": "317011958",
            "telephone_number": "229-312-5800",
            "fax_number": "229-312-5853"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "507 W 3RD AVE",
            "address_2": "STE 3",
            "city": "ALBANY",
            "state": "GA",
            "postal_code": "317011958",
            "telephone_number": "229-312-5800",
            "fax_number": "229-312-5853"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHOEBE INFECTIOUS DISEASE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PHOEBE PHYSICIAN GROUP INC",
        "enumeration_date": "2010-12-20",
        "last_updated": "2010-12-20",
        "status": "A",
        "authorized_official_last_name": "LAGESSE",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "SR VP PHYSICIAN PRACTICES",
        "authorized_official_telephone_number": "229-312-1000"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Dec 20, 2010; 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.