NPIMap

Organization Active NPI

Upson Family Medical Center ,LLC

  • Family Medicine Physician
  • Thomaston, GA
National Provider Identifier
1124528344
Registry record updated Feb 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
UPSON FAMILY MEDICAL CENTER ,LLC
Practice address
1512 Highway 19 N
Thomaston, GA 30286-2258
Phone
(706) 647-2641
NPI assigned
Feb 14, 2018
Last updated
Feb 2, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2026

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

Authorized official

Name
Daniel Owens
Title
Ceo
Phone
(706) 647-8111

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

1512 Highway 19 N
Thomaston, GA 30286-2258

Mailing address

801 W Gordon St
Thomaston, GA 30286-3426
Phone (706) 647-8111

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180409001182 GA Part B Supplier - Clinic/Group Practice 9032472824 Receives reassigned benefits from 13 practitioners
Practice locations: Thomaston, GA

National Provider Directory

National Provider Directory

Member of 1

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

Practitioners & affiliated clinicians

Practitioners 13

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 13

NPI Registry JSON

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

{
    "created_epoch": "1518566400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1769990400000",
    "number": "1124528344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 W GORDON ST",
            "city": "THOMASTON",
            "state": "GA",
            "postal_code": "302863426",
            "telephone_number": "706-647-8111",
            "fax_number": "706-647-4389"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1512 HIGHWAY 19 N",
            "city": "THOMASTON",
            "state": "GA",
            "postal_code": "302862258",
            "telephone_number": "706-647-2641"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UPSON FAMILY MEDICAL CENTER ,LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-02-14",
        "last_updated": "2026-02-02",
        "certification_date": "2026-02-02",
        "status": "A",
        "authorized_official_last_name": "OWENS",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "706-647-8111"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Thomaston, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2026; 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.