Medplus Immediate Care

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

Legal business name

MEDPLUS IMMEDIATE CARE

Practice address

5585 Thomaston Rd Ste A600
Macon, GA 31220-8200

Phone

(478) 219-9514

Fax

(478) 259-2836

NPI assigned

Jul 30, 2021

Last updated

Aug 10, 2021By 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

John Souza, MDNPI 1699718056

Title

Owner

Phone

(478) 219-9514

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Tax ID family

Medplus Immediate Care2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Medplus Immediate Care

  • General Practice Physician
  • Macon, GA
  • NPI 1164198461
  NPD tax ID

Locations

Practitioners 9

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.

• John W Souza, MD

  • Emergency Medicine Physician
  • Dublin, GA
  • NPI 1699718056

  General Practice

  Medicare reassignment NPD Authorized official
• Renee Nichols Bailey, FNPC

  • Family Nurse Practitioner
  • Fort Valley, GA
  • NPI 1407018872

  General Practice

  Medicare reassignment NPD
• Gregory Daniel Bennett, MD

  • Internal Medicine Physician
  • Macon, GA
  • NPI 1366651507
  Medicare reassignment NPD
• Angela Kennedy Bullard, FNP-BC

  • Family Nurse Practitioner
  • Tifton, GA
  • NPI 1730681495
  Medicare reassignment NPD
• Detra K Dixon, FNP

  • Family Nurse Practitioner
  • Macon, GA
  • NPI 1376101196

  Single Specialty

  Medicare reassignment NPD
• Herschel L Kessler, DO

  • Family Medicine Physician
  • Jasper, GA
  • NPI 1952612103
  Medicare reassignment NPD
• Michael Beavers, APRN

  • Family Nurse Practitioner
  • West Columbia, SC
  • NPI 1588225106

  GA

  Medicare reassignment NPD
• Laurajane Elizabeth Martin, APRN

  • Family Nurse Practitioner
  • Columbia, SC
  • NPI 1932985611
  NPD
• Anna Roland, FNP

  • Family Nurse Practitioner
  • Byron, GA
  • NPI 1508719279
  NPD (past)

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

{
    "created_epoch": "1627603200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1628553600000",
    "number": "1215600564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 HILLCREST PKWY STE L",
            "city": "DUBLIN",
            "state": "GA",
            "postal_code": "310213581",
            "telephone_number": "478-272-8140",
            "fax_number": "478-277-0276"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5585 THOMASTON RD STE A600",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312208200",
            "telephone_number": "478-219-9514",
            "fax_number": "478-259-2836"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDPLUS IMMEDIATE CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-30",
        "last_updated": "2021-08-10",
        "certification_date": "2021-08-10",
        "status": "A",
        "authorized_official_last_name": "SOUZA",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "478-219-9514",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Medplus Immediate Care
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• Medrad, LLC
• Robert Adam Medrzycki, PT
• Medway Emergency Medical Services Inc.
• Glen A Megran, PA-C

• General Practice Physician in Macon, GA
• Providers in Macon, GA by specialty
• General Practice Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2021; 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.