NPIMap

Organization Active NPI

Urgent Care Banks Crossing LLC

  • General Practice Physician
  • Commerce, GA
National Provider Identifier
1386802155
Registry record updated Dec 28, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
URGENT CARE BANKS CROSSING LLC
Practice address
415 B Pottery Factory Drive
Commerce, GA 30529
Phone
(706) 336-0074
Fax
(706) 336-0079
NPI assigned
May 29, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2009

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

Authorized official

Name
Mrs. Lisa A Brookshire
Title
Office Manager
Phone
(706) 336-0074

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207L00000X 049138 GA
Surgery PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 208600000X 049138 GA
General Practice PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 208D00000X GA Primary
Pain Medicine PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 208VP0000X 049138 GA

Addresses

Primary practice location

415 B Pottery Factory Drive
Commerce, GA 30529

Mailing address

P.O. Box 1055
Commerce, GA 30529
Phone (706) 336-0074

Other identifiers 4

IdentifierTypeStateIssuer
971545216BMedicaidGA
1497763254OtherGANPI
000771999HMedicaidGA
1033127899OtherGANPI

Other names 1

  • Commerce Surgical Associates Former legal business name

National Provider Directory

National Provider Directory

Locations

415 Pottery Factory Dr
#B
Commerce, GA 30529
Phone (706) 336-0074

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1212019200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1261958400000",
    "number": "1386802155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 1055",
            "city": "COMMERCE",
            "state": "GA",
            "postal_code": "30529",
            "telephone_number": "706-336-0074",
            "fax_number": "706-336-0079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 B POTTERY FACTORY DRIVE",
            "city": "COMMERCE",
            "state": "GA",
            "postal_code": "30529",
            "telephone_number": "706-336-0074",
            "fax_number": "706-336-0079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "URGENT CARE BANKS CROSSING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-29",
        "last_updated": "2009-12-28",
        "status": "A",
        "authorized_official_last_name": "BROOKSHIRE",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "706-336-0074",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Anesthesiology",
            "state": "GA",
            "license": "049138",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Surgery",
            "state": "GA",
            "license": "049138",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "General Practice",
            "state": "GA",
            "license": null,
            "primary": true
        },
        {
            "code": "208VP0000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "GA",
            "license": "049138",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "971545216B",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1497763254",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000771999H",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1033127899",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Commerce Surgical Associates",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Commerce, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2009; 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.