NPIMap

Organization Active NPI

Dr. F. Geoffery Conner PC

  • Internal Medicine Physician
  • Vidalia, GA
National Provider Identifier
1376729228
Registry record updated Jul 22, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
033555 Issued in GA
Legal business name
DR. F. GEOFFERY CONNER PC
Practice address
1608 Meadows LN Ste 1
Vidalia, GA 30474-9907
Phone
(912) 537-9488
Fax
(912) 537-8951
NPI assigned
Jan 10, 2008
Last updated
Jul 22, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2008

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

Authorized official

Name
Cathy Sikes
Title
Billing Clerk
Phone
(912) 537-9488

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 033555 GA Primary

Addresses

Primary practice location

1608 Meadows LN Ste 1
Vidalia, GA 30474-9907

Mailing address

1608 Meadows LN Ste 1
Vidalia, GA 30474-9907
Phone (912) 537-9488

Other identifiers 1

IdentifierTypeStateIssuer
000479014EMedicaidGA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040414000368 GA Part B Supplier - Clinic/Group Practice 8628062353 Receives reassigned benefits from 9 practitioners
Practice locations: Vidalia, GA

National Provider Directory

National Provider Directory

Locations

125A Victory Dr
Swainsboro, GA 30401
Phone (478) 237-5527

1608 Meadows Ln
Ste 1
Vidalia, GA 30474
Phone (912) 537-8951

Practitioners & affiliated clinicians

Practitioners 10

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": "1199923200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1216684800000",
    "number": "1376729228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1608 MEADOWS LN STE 1",
            "city": "VIDALIA",
            "state": "GA",
            "postal_code": "304749907",
            "telephone_number": "912-537-9488",
            "fax_number": "912-537-8951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1608 MEADOWS LN STE 1",
            "city": "VIDALIA",
            "state": "GA",
            "postal_code": "304749907",
            "telephone_number": "912-537-9488",
            "fax_number": "912-537-8951"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. F. GEOFFERY CONNER PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-10",
        "last_updated": "2008-07-22",
        "status": "A",
        "authorized_official_last_name": "SIKES",
        "authorized_official_first_name": "CATHY",
        "authorized_official_title_or_position": "BILLING CLERK",
        "authorized_official_telephone_number": "912-537-9488"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "033555",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000479014E",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Vidalia, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2008; 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.