Coffee Family Medicine, PC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

53885 Issued in GA

Legal business name

COFFEE FAMILY MEDICINE, PC

Practice address

200 Doctors Dr
Suite 224
Douglas, GA 31533-2201

Phone

(912) 384-2353

NPI assigned

Jul 27, 2006

Last updated

Jan 19, 2012By 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

Dr. Lydia Tanner, M.D.

Title

Physician

Phone

(912) 384-2353

Specialties & licenses 2

Addresses

Locations

Practitioners 2

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.

• Linda Jo Saunders, M.D

  • General Practice Physician
  • Buford, GA
  • NPI 1124062229
  NPD (past)
• Kevin Kennedy Trapnell, MD

  • Family Medicine Physician
  • Evans, GA
  • NPI 1083796619
  NPD (past)

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

{
    "created_epoch": "1153958400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1326931200000",
    "number": "1265456669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 DOCTORS DR",
            "address_2": "SUITE 224",
            "city": "DOUGLAS",
            "state": "GA",
            "postal_code": "315332201",
            "telephone_number": "912-384-2353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 DOCTORS DR",
            "address_2": "SUITE 224",
            "city": "DOUGLAS",
            "state": "GA",
            "postal_code": "315332201",
            "telephone_number": "912-384-2353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COFFEE FAMILY MEDICINE, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-27",
        "last_updated": "2012-01-19",
        "status": "A",
        "authorized_official_last_name": "TANNER",
        "authorized_official_first_name": "LYDIA",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "912-384-2353",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "53885",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "004691",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Coffee County Pediatrics PC
• Coffee County Sleep Services, LLC
• Coffee CS Comp
• Coffee Emergency Group LLC
• Coffee Family Medicine
• Coffee Regional Medical Center
• Coffee Regional Medical Center
• Coffee Regional Medical Center
• Coffee Regional Medical Center, Inc (Coffee Regional Medical Center)
• Coffee Regional Medical Center, Inc

• Family Medicine Physician in Douglas, GA
• Providers in Douglas, 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 19, 2012; 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.