West Georgia Medical Center, Inc.

Primary specialty

Registered DietitianTaxonomy code 133V00000X

Legal business name

WEST GEORGIA MEDICAL CENTER, INC.

Doing business as

West Georgia Medical Center

Practice address

1514 Vernon Rd
Lagrange, GA 30240-4131

Phone

(706) 882-1411

Fax

(706) 845-8918

NPI assigned

Mar 5, 2010

Organization subpart

Yes

Parent organization

WEST GEORGIA MEDICAL CENTER, INC.As reported in NPPES

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

Authorized official

Name

Mr. Gerald N. Fulks

Title

President/Ceo

Phone

(706) 845-3702

Specialties & licenses 1

Addresses

Other names 1

• West Georgia Medical Center Doing business as

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Other NPIs on the same Medicare enrollment 3

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

• West Georgia Medical Center Inc

  • Interventional Cardiology Physician
  • Lagrange, GA
  • NPI 1558592089

  O20091207000333

  Same enrollment
• West Georgia Medical Center Inc

  • Urology Physician
  • Lagrange, GA
  • NPI 1689985954

  O20091207000333

  Same enrollment
• West Georgia Medical Center, Inc.

  • General Acute Care Hospital
  • Lagrange, GA
  • NPI 1821221144

  O20091207000333

  Same enrollment

Part of

West Georgia Medical Center Inc

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

{
    "created_epoch": "1267747200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1412726400000",
    "number": "1356664247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1514 VERNON RD",
            "city": "LAGRANGE",
            "state": "GA",
            "postal_code": "302404131",
            "telephone_number": "706-882-1411",
            "fax_number": "706-845-8918"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1514 VERNON RD",
            "city": "LAGRANGE",
            "state": "GA",
            "postal_code": "302404131",
            "telephone_number": "706-882-1411",
            "fax_number": "706-845-8918"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST GEORGIA MEDICAL CENTER, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WEST GEORGIA MEDICAL CENTER, INC.",
        "enumeration_date": "2010-03-05",
        "last_updated": "2014-10-08",
        "status": "A",
        "authorized_official_last_name": "FULKS",
        "authorized_official_first_name": "GERALD",
        "authorized_official_middle_name": "N.",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "706-845-3702",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "West Georgia Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• West Georgia Medical Center Inc
• West Georgia Medical Center Inc
• West Georgia Medical Center, Inc
• West Georgia Medical Center, Inc
• West Georgia Medical Center, Inc.
• West Georgia Medical Center, Inc.
• West Georgia Medical Center, Inc.
• West Georgia Medical Center, Inc.
• West Georgia Medical Center, Inc.
• West Georgia Medical Center, Inc.

• Registered Dietitian in Lagrange, GA
• Providers in Lagrange, GA by specialty
• Registered Dietitian in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 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.