NPIMap

Organization Active NPI

Csra Surgical Solutions PC

  • Surgery Physician
  • Augusta, GA
National Provider Identifier
1346217908
Registry record updated Nov 2, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
CSRA SURGICAL SOLUTIONS PC
Practice address
3624 J Dewey Gray Cir
Suite 250
Augusta, GA 30909-6667
Phone
(706) 855-9565
NPI assigned
Mar 2, 2006
Last updated
Nov 2, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2011

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

Authorized official

Name
Sharon Wilder
Title
Ins Billing Dept
Phone
(706) 863-9595

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X NU Primary

Addresses

Primary practice location

3624 J Dewey Gray Cir
Suite 250
Augusta, GA 30909-6667

Mailing address

3624 J Dewey Gray Cir
Suite 250
Augusta, GA 30909-6667
Phone (706) 855-9565

Other identifiers 1

IdentifierTypeStateIssuer
000713402CMedicaidGA

National Provider Directory

National Provider Directory

Locations

3624 J Dewey Gray Cir
Ste 250
Augusta, GA 30909
Phone (706) 855-9565

Practitioners & affiliated clinicians

Practitioners 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1141257600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1320192000000",
    "number": "1346217908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3624 J DEWEY GRAY CIR",
            "address_2": "SUITE 250",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309096667",
            "telephone_number": "706-855-9565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3624 J DEWEY GRAY CIR",
            "address_2": "SUITE 250",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309096667",
            "telephone_number": "706-855-9565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CSRA SURGICAL SOLUTIONS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-02",
        "last_updated": "2011-11-02",
        "status": "A",
        "authorized_official_last_name": "WILDER",
        "authorized_official_first_name": "SHARON",
        "authorized_official_title_or_position": "INS BILLING DEPT",
        "authorized_official_telephone_number": "706-863-9595"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000713402C",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Augusta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2011; 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.