NPIMap

Organization Active NPI

Phoebe Physician Group, Inc

  • Clinical Cardiac Electrophysiology Physician
  • Albany, GA
National Provider Identifier
1255794541
Registry record updated Apr 4, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Cardiac Electrophysiology PhysicianTaxonomy code 207RC0001X
License
059422 Issued in GA
Legal business name
PHOEBE PHYSICIAN GROUP, INC
Practice address
425 W 3Rd Ave Ste 700
Albany, GA 31701-1969
Phone
(229) 312-7790
Fax
(229) 312-7795
NPI assigned
Apr 4, 2016
Last updated
Apr 4, 2016By the provider in NPPES
Organization subpart
Yes
Parent organization
PHOEBE PHYSICIAN GROUP, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 4, 2016

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

Authorized official

Name
Jeff Head
Title
Cfo
Phone
(229) 312-6721

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 059422 GA
Clinical Cardiac Electrophysiology Physician 207RC0001X 059422 GA Primary

Addresses

Primary practice location

425 W 3Rd Ave Ste 700
Albany, GA 31701-1969

Mailing address

500 W 3Rd Ave
Ste 101
Albany, GA 31701-1985
Phone (229) 312-5800

Other names 1

  • Phoebe Electrophysiology Other name

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
11D2126384Phoebe Electrophysiology425 W Third Avenue, Suite 700, Albany, GA 31701Certificate of waiverFeb 26, 2027

National Provider Directory

National Provider Directory
Tax ID family
Phoebe Family Medicinecoffee County26 organizations share this tax ID, including this one
Part of
Phoebe Family Medicinecoffee County

Other organizations with this tax ID 25

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

View all 25

NPI Registry JSON

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

{
    "created_epoch": "1459728000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1459728000000",
    "number": "1255794541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 W 3RD AVE",
            "address_2": "STE 101",
            "city": "ALBANY",
            "state": "GA",
            "postal_code": "317011985",
            "telephone_number": "229-312-5800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 W 3RD AVE STE 700",
            "city": "ALBANY",
            "state": "GA",
            "postal_code": "317011969",
            "telephone_number": "229-312-7790",
            "fax_number": "229-312-7795"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHOEBE PHYSICIAN GROUP, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PHOEBE PHYSICIAN GROUP, INC",
        "enumeration_date": "2016-04-04",
        "last_updated": "2016-04-04",
        "status": "A",
        "authorized_official_last_name": "HEAD",
        "authorized_official_first_name": "JEFF",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "229-312-6721"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "GA",
            "license": "059422",
            "primary": false
        },
        {
            "code": "207RC0001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Clinical Cardiac Electrophysiology",
            "state": "GA",
            "license": "059422",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Phoebe Electrophysiology",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Albany, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.