Organization Active NPI

Badia Medical, LLC

Doing business as Cochran Family MedicaL Center

  • Family Medicine Physician
  • Cochran, GA
National Provider Identifier
1144025784
Registry record updated Feb 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
BADIA MEDICAL, LLC
Doing business as
Cochran Family MedicaL Center
Practice address
179 W Dykes St
Cochran, GA 31014-6921
Phone
(478) 922-3074
NPI assigned
Feb 18, 2025
Last updated
Feb 18, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
BADIA MEDICAL LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 18, 2025

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

Authorized official

Name
Ashley Defore
Title
Office Manager
Phone
(478) 922-3074

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary

Addresses

Primary practice location

179 W Dykes St
Cochran, GA 31014-6921

Mailing address

107 Peacock Dr
Warner Robins, GA 31088-3637
Phone (478) 922-3074

Other names 1

  • Cochran Family MedicaL Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250516002734 GA Part B Supplier - Clinic/Group Practice 7416475074 Receives reassigned benefits from 3 practitioners
Practice locations: Cochran, GA

National Provider Directory

National Provider Directory
Part of
Badia Medical LLC

Locations

179 W Dykes St
Cochran, GA 31014
Phone (478) 922-3074

Practitioners & affiliated clinicians

Practitioners 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1739836800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1739836800000",
    "number": "1144025784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 PEACOCK DR",
            "city": "WARNER ROBINS",
            "state": "GA",
            "postal_code": "310883637",
            "telephone_number": "478-922-3074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "179 W DYKES ST",
            "city": "COCHRAN",
            "state": "GA",
            "postal_code": "310146921",
            "telephone_number": "478-922-3074"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BADIA MEDICAL, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BADIA MEDICAL LLC",
        "enumeration_date": "2025-02-18",
        "last_updated": "2025-02-18",
        "certification_date": "2025-02-18",
        "status": "A",
        "authorized_official_last_name": "DEFORE",
        "authorized_official_first_name": "ASHLEY",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "478-922-3074"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cochran Family MedicaL Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Cochran, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2025; 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.