Georgia Psychiatric and Addiction Clinic P.C.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

031577 Issued in GA

Legal business name

GEORGIA PSYCHIATRIC AND ADDICTION CLINIC P.C.

Practice address

1211 Palmyra Rd
Albany, GA 31701-1935

Phone

(229) 439-8686

Fax

(229) 883-4484

NPI assigned

May 24, 2010

Organization subpart

No

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

Authorized official

Name

Dr. William Edwin Coleman II, M.D.NPI 1134157381

Title

Psychiatrist

Phone

(229) 439-8686

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

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

CLIA laboratory certificates

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• William Edwin Coleman Jr., M.D.

  • Addiction Psychiatry Physician
  • Albany, GA
  • NPI 1134157381
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1274659200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1274659200000",
    "number": "1356660898",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1211 PALMYRA RD",
            "city": "ALBANY",
            "state": "GA",
            "postal_code": "317011935",
            "telephone_number": "229-439-8686",
            "fax_number": "229-883-4484"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1211 PALMYRA RD",
            "city": "ALBANY",
            "state": "GA",
            "postal_code": "317011935",
            "telephone_number": "229-439-8686",
            "fax_number": "229-883-4484"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GEORGIA PSYCHIATRIC AND ADDICTION CLINIC P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-05-24",
        "last_updated": "2010-05-24",
        "status": "A",
        "authorized_official_last_name": "COLEMAN",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "EDWIN",
        "authorized_official_title_or_position": "PSYCHIATRIST",
        "authorized_official_telephone_number": "229-439-8686",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "II",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "GA",
            "license": "031577",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000463526L",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Cheryl Gervin-Clark, NP-C
• Kasandra Renea Gervin

• Psychiatry Physician in Albany, GA
• Providers in Albany, GA by specialty
• Psychiatry Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.