Individual provider Active NPI

Mark Lenon Cain, MD

  • Urology Physician
  • Evans, GA
National Provider Identifier
1174558191
Registry record updated Mar 30, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
35020 Issued in GA
Practice address
4350 Towne Centre Dr Ste 2200
Evans, GA 30809-3301
Phone
(706) 722-0705
Fax
(762) 333-0496
NPI assigned
Jul 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 35020 GA Primary

Addresses

Primary practice location

4350 Towne Centre Dr Ste 2200
Evans, GA 30809-3301

Mailing address

4350 Towne Centre Dr Ste 2200
Evans, GA 30809-3301
Phone (706) 722-0705

Other identifiers 1

IdentifierTypeStateIssuer
00597594AMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Augusta Urology Associates, LLC CurrentSince Feb 1, 2022 Accepting new patients

Locations

818 Saint Sebastian Way
Ste 403
Augusta, GA 30901
Phone (706) 722-0705

4350 Towne Centre Dr
Ste 2200
Evans, GA 30809
Phone (706) 722-0705

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1152576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1427673600000",
    "number": "1174558191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4350 TOWNE CENTRE DR STE 2200",
            "city": "EVANS",
            "state": "GA",
            "postal_code": "308093301",
            "telephone_number": "706-722-0705",
            "fax_number": "762-333-0496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4350 TOWNE CENTRE DR STE 2200",
            "city": "EVANS",
            "state": "GA",
            "postal_code": "308093301",
            "telephone_number": "706-722-0705",
            "fax_number": "762-333-0496"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAIN",
        "first_name": "MARK",
        "middle_name": "LENON",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-11",
        "last_updated": "2015-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "GA",
            "license": "35020",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00597594A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Evans, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.