The Corporation of Mercer University

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

THE CORPORATION OF MERCER UNIVERSITY

Doing business as

Mercer Medicine

Practice address

250 Martin Luther King Jr Blvd
Macon, GA 31201-3490

Phone

(478) 301-4111

Fax

(478) 301-2272

NPI assigned

Nov 8, 2006

Last updated

Jan 26, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Charles Duffey

Title

Coo

Phone

(478) 301-2362

Specialties & licenses 15

Addresses

Other identifiers 2

Other names 2

• Mercer Medicine Doing business as
• Mercer Health Systems Former legal business name

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• The Corporation of Mercer University

  dba Mercer University Center for IDD Care

  • Multi-Specialty Clinic/Center
  • Macon, GA
  • NPI 1841171998

  7618968066

  Same PAC ID

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Mercer Physical Therapy

  • Physical Therapy Clinic/Center
  • Atlanta, GA
  • NPI 1477861904

  O20040524000431

  Same enrollment
• Movement Sports Physical Therapy, LLC

  • Physical Therapist
  • Atlanta, GA
  • NPI 1902144793

  O20040524000431

  Same enrollment

Locations

Practitioners 57

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.

• Caitlin Forkin

  • Physical Therapist
  • Atlanta, GA
  • NPI 1295565307
  Medicare reassignment Care Compare group NPD
• Taylor Augusta McDermott, DPT

  • Physical Therapist
  • Atlanta, GA
  • NPI 1588550545
  Medicare reassignment Care Compare group NPD
• Timothy John McMahon, PT, OCS

  • Orthopedic Physical Therapist
  • Atlanta, GA
  • NPI 1982911590
  Medicare reassignment Care Compare group NPD
• Allison Marie Ball, MSN, APRN, FNP-C

  • Family Nurse Practitioner
  • Fort Valley, GA
  • NPI 1932606043
  Medicare reassignment NPD
• Stephanie Alexandra Beavers, MD

  • Internal Medicine Physician
  • Macon, GA
  • NPI 1831457274
  Medicare reassignment NPD
• Melissa Dawn Belcher, FNP

  • Family Nurse Practitioner
  • Eatonton, GA
  • NPI 1891251534
  Medicare reassignment NPD
• Douglas Alan Brewer, MD

  • Colon & Rectal Surgery Physician
  • Macon, GA
  • NPI 1194727651
  Medicare reassignment NPD
• Lynn Taylor Denny, M.D.

  • Family Medicine Physician
  • Macon, GA
  • NPI 1447474184
  Medicare reassignment NPD
• Douglas Paul Farman, M.D.

  • Pulmonary Disease Physician
  • Macon, GA
  • NPI 1144310954
  Medicare reassignment NPD
• Patricia Barrett Fennessy, MD

  • Obstetrics & Gynecology Physician
  • Plains, GA
  • NPI 1144407917
  Medicare reassignment NPD
• Edwin W Grimsley, MD

  • Internal Medicine Physician
  • Macon, GA
  • NPI 1952486920
  Medicare reassignment NPD
• Angela J Hale, M.D.

  • Psychiatry Physician
  • Macon, GA
  • NPI 1881648780

  Child & Adolescent Psychiatry

  Medicare reassignment NPD

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

{
    "created_epoch": "1162944000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1643155200000",
    "number": "1174693162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 MARTIN LUTHER KING JR BLVD",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312013490",
            "telephone_number": "478-301-2362",
            "fax_number": "478-301-2272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 MARTIN LUTHER KING JR BLVD",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312013490",
            "telephone_number": "478-301-4111",
            "fax_number": "478-301-2272"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1550 College Street",
            "address_purpose": "LOCATION",
            "city": "Macon",
            "state": "GA",
            "postal_code": "312071554",
            "country_code": "US",
            "telephone_number": "478-301-2397",
            "fax_number": "478-301-2128",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "THE CORPORATION OF MERCER UNIVERSITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-08",
        "last_updated": "2022-01-26",
        "certification_date": "2022-01-26",
        "status": "A",
        "authorized_official_last_name": "DUFFEY",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "478-301-2362"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084F0202X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Forensic Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0805X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Geriatric Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P2900X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Pain Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CC1498",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300018450U",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mercer Medicine",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Mercer Health Systems",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Mercer Health Systems",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Family Medicine Physician in Macon, GA
• Providers in Macon, GA by specialty
• Family Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2022; 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.