Organization Active NPI

Central Georgia Adrenal and Reproductive Endocrinology

  • Endocrinology, Diabetes & Metabolism Physician
  • McDonough, GA
National Provider Identifier
1174335145
Registry record updated Jan 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
Legal business name
CENTRAL GEORGIA ADRENAL AND REPRODUCTIVE ENDOCRINOLOGY
Practice address
374 Racetrack Rd
McDonough, GA 30252-1022
Phone
(801) 657-8137
Fax
(801) 657-8137
NPI assigned
Jan 24, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2025

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

Authorized official

Name
Hansel Mark Rayner, PA-CNPI 1972761732
Title
Owner
Phone
(470) 317-3855

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RE0101X Primary
Ambulatory Fertility Facility 261QA0006X

Addresses

Primary practice location

374 Racetrack Rd
McDonough, GA 30252-1022

Mailing address

121 Lighthorse Blvd
McDonough, GA 30252-2998
Phone (801) 657-8137

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250505000462 GA Part B Supplier - Clinic/Group Practice 2466979414 Receives reassigned benefits from 1 practitioner
Practice locations: McDonough, GA

National Provider Directory

National Provider Directory

Locations

374 Racetrack Rd
McDonough, GA 30252
Phone (470) 317-3855

Practitioners & affiliated clinicians

Practitioners 2

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": "1737676800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1737676800000",
    "number": "1174335145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 LIGHTHORSE BLVD",
            "city": "MCDONOUGH",
            "state": "GA",
            "postal_code": "302522998",
            "telephone_number": "801-657-8137"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "374 RACETRACK RD",
            "city": "MCDONOUGH",
            "state": "GA",
            "postal_code": "302521022",
            "telephone_number": "801-657-8137",
            "fax_number": "801-657-8137"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL GEORGIA ADRENAL AND REPRODUCTIVE ENDOCRINOLOGY",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-01-24",
        "last_updated": "2025-01-24",
        "certification_date": "2025-01-24",
        "status": "A",
        "authorized_official_last_name": "RAYNER",
        "authorized_official_first_name": "HANSEL",
        "authorized_official_middle_name": "MARK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "470-317-3855",
        "authorized_official_credential": "PA-C"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QA0006X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Fertility Facility",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in McDonough, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 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.