NPIMap

Organization Active NPI

Healogics Specialty Physicians of Georgia, LLC

Doing business as Middle Georgia Wound Care By Healogics

  • Multi-Specialty Clinic/Center
  • Cumming, GA
National Provider Identifier
1336790468
Registry record updated Jun 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
HEALOGICS SPECIALTY PHYSICIANS OF GEORGIA, LLC
Doing business as
Middle Georgia Wound Care By Healogics
Practice address
2575 Peachtree Pkwy Ste 250
Cumming, GA 30041-7563
Phone
(478) 405-7996
Fax
(478) 405-7998
NPI assigned
Sep 20, 2019
Last updated
Jun 1, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2023

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

Authorized official

Name
Frank Williams
Title
Ceo
Phone
(904) 446-3519

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X Primary
Undersea and Hyperbaric Medicine (Preventive Medicine) Physician 2083P0011X

Addresses

Primary practice location

2575 Peachtree Pkwy Ste 250
Cumming, GA 30041-7563

Mailing address

PO Box 645743
Cincinnati, OH 45264-6018
Phone (855) 689-5105

Other names 1

  • Middle Georgia Wound Care By Healogics Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140813001916 GA Part B Supplier - Clinic/Group Practice 7214154392 Receives reassigned benefits from 23 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Columbus, GA; Waycross, GA; Thomasville, GA; Monroe, GA; Macon, GA; Lavonia, GA; Cumming, GA

Other NPIs on the same Medicare enrollment 1

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

National Provider Directory

National Provider Directory
Tax ID family
Healogics Specialty Physicians of Georgi2 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.

Locations

619 19TH St
Ste 300
Columbus, GA 31901
Phone (706) 320-8685

100 Mimosa Dr
Ste 1L
Thomasville, GA 31792
Phone (229) 228-2410

Practitioners & affiliated clinicians

Practitioners 17

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 17

NPI Registry JSON

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

{
    "created_epoch": "1568937600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1685577600000",
    "number": "1336790468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 645743",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452646018",
            "telephone_number": "855-689-5105",
            "fax_number": "904-446-3032"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2575 PEACHTREE PKWY STE 250",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300417563",
            "telephone_number": "478-405-7996",
            "fax_number": "478-405-7998"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALOGICS SPECIALTY PHYSICIANS OF GEORGIA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-09-20",
        "last_updated": "2023-06-01",
        "certification_date": "2023-06-01",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "FRANK",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "904-446-3519"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2083P0011X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Undersea and Hyperbaric Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Middle Georgia Wound Care By Healogics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Cumming, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2023; 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.