NPIMap

Organization Active NPI

Phoebe Urology

  • Clinic/Center
  • Albany, GA
National Provider Identifier
1356691257
Registry record updated Sep 18, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
PHOEBE UROLOGY
Practice address
425 W 3Rd Ave
Ste 550
Albany, GA 31701-1999
Phone
(229) 322-8463
Fax
(229) 312-1970
NPI assigned
Sep 18, 2012
Last updated
Sep 18, 2012By the provider in NPPES
Organization subpart
Yes
Parent organization
PHOEBE PHYSICIAN GROUP INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 18, 2012

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

Authorized official

Name
Robert Lagesse
Title
Sr VP Physician Services
Phone
(229) 312-1000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

425 W 3Rd Ave
Ste 550
Albany, GA 31701-1999

Mailing address

500 W 3Rd Ave
Ste 101
Albany, GA 31701-1985
Phone (229) 312-5800

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090121000583 GA Part B Supplier - Clinic/Group Practice 8426112350 Receives reassigned benefits from 1,136 practitioners
14 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment

Other NPIs on the same Medicare enrollment 14

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

View all 14

National Provider Directory

National Provider Directory
Tax ID family
Phoebe Dorminy Family Care26 organizations share this tax ID, including this one
Part of
Phoebe Dorminy Family Care

Other organizations with this tax ID 25

Organizations that report the same tax identification number in the National Provider Directory.

View all 25

Locations

1950 Palmyra Rd
Albany, GA 31701
Phone (229) 883-1503

151 Mayo St
Ste B
Americus, GA 31709
Phone (229) 928-2900

Practitioners & affiliated clinicians

Practitioners 26

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 26

NPI Registry JSON

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

{
    "created_epoch": "1347926400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1347926400000",
    "number": "1356691257",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 W 3RD AVE",
            "address_2": "STE 101",
            "city": "ALBANY",
            "state": "GA",
            "postal_code": "317011985",
            "telephone_number": "229-312-5800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 W 3RD AVE",
            "address_2": "STE 550",
            "city": "ALBANY",
            "state": "GA",
            "postal_code": "317011999",
            "telephone_number": "229-322-8463",
            "fax_number": "229-312-1970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHOEBE UROLOGY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PHOEBE PHYSICIAN GROUP INC",
        "enumeration_date": "2012-09-18",
        "last_updated": "2012-09-18",
        "status": "A",
        "authorized_official_last_name": "LAGESSE",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "SR VP PHYSICIAN SERVICES",
        "authorized_official_telephone_number": "229-312-1000"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albany, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2012; 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.