NPIMap

Organization Active NPI

Umg General Surgery LLC

Doing business as UMG General Surgery

  • Surgery Physician
  • Thomson, GA
National Provider Identifier
1306250907
Registry record updated Jun 12, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
UMG GENERAL SURGERY LLC
Doing business as
UMG General Surgery
Practice address
604 Ware St
Thomson, GA 30824-2133
Phone
(706) 774-7263
Fax
(706) 774-7230
NPI assigned
Jun 12, 2014
Last updated
Jun 12, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2014

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

Authorized official

Name
Dave Belkoski
Title
Cfo, Executive VP
Phone
(706) 774-7263

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X NU Primary

Addresses

Primary practice location

604 Ware St
Thomson, GA 30824-2133

Mailing address

PO Box 1705
Augusta, GA 30903-1705
Phone (706) 774-7263

Other names 1

  • UMG General Surgery Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20141021002506 GA Part B Supplier - Clinic/Group Practice 4587885249 Receives reassigned benefits from 12 practitioners
Practice locations: Augusta, GA; Grovetown, GA; Thomson, GA

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

818 Saint Sebastian Way
Ste 101
Augusta, GA 30901
Phone (706) 434-0130

Practitioners & affiliated clinicians

Practitioners 21

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.

View all 21

NPI Registry JSON

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

{
    "created_epoch": "1402531200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1402531200000",
    "number": "1306250907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1705",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309031705",
            "telephone_number": "706-774-7263",
            "fax_number": "706-774-7230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "604 WARE ST",
            "city": "THOMSON",
            "state": "GA",
            "postal_code": "308242133",
            "telephone_number": "706-774-7263",
            "fax_number": "706-774-7230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UMG GENERAL SURGERY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-12",
        "last_updated": "2014-06-12",
        "status": "A",
        "authorized_official_last_name": "BELKOSKI",
        "authorized_official_first_name": "DAVE",
        "authorized_official_title_or_position": "CFO, EXECUTIVE VP",
        "authorized_official_telephone_number": "706-774-7263"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "UMG General Surgery",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Thomson, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2014; 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.