Csra Medical Associates

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

CSRA MEDICAL ASSOCIATES

Practice address

2123 Wrightsboro Rd
Augusta, GA 30904-4777

Phone

(706) 736-5244

Fax

(706) 736-5246

NPI assigned

Aug 25, 2006

Organization subpart

No

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

Authorized official

Name

Miss Merryll Lynnette Washington

Title

Office Manager

Phone

(706) 736-8519

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in GA, SC2 enrollments

Enrollment records 2

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 3

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

• Calvin R Jackson

  • Internal Medicine Physician
  • Augusta, GA
  • NPI 1740398338

  GA, Internal Medicine, SC

  Medicare reassignment NPD
• James Alvin Cato III, MD

  • Single Specialty Group
  • Augusta, GA
  • NPI 1679681183

  SC

  Medicare reassignment
• Blondenia Labrew, NP

  • Nurse Practitioner
  • Aiken, SC
  • NPI 1578039798
  NPD (past)

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

{
    "created_epoch": "1156464000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1292284800000",
    "number": "1164530689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2123 WRIGHTSBORO RD",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309044777",
            "telephone_number": "706-736-5244",
            "fax_number": "706-736-5246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2123 WRIGHTSBORO RD",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309044777",
            "telephone_number": "706-736-5244",
            "fax_number": "706-736-5246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CSRA MEDICAL ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-25",
        "last_updated": "2010-12-14",
        "status": "A",
        "authorized_official_last_name": "WASHINGTON",
        "authorized_official_first_name": "MERRYLL",
        "authorized_official_middle_name": "LYNNETTE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "706-736-8519",
        "authorized_official_name_prefix": "Miss"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GPA645",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "85001833G",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Csra Holdings LLC
• Csra Holdings LLC
• Csra Holdings LLC
• Csra Internal Medicine Associates, PC
• Csra Magnolia Chiropractic & Wellness LLC
• Csra Neurology,LLC
• Csra Pediatrics
• Csra Plastic Surgery Associates PC
• Csra Sleep LLC
• Csra Surgical Solutions PC

• Internal Medicine Physician in Augusta, GA
• Providers in Augusta, GA by specialty
• Internal Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.