Individual provider Active NPI

Caitlin Lazurick Gann, DO

  • Pediatrics Physician
  • Saint Marys, GA
National Provider Identifier
1396435756
Registry record updated Jul 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
113304 Issued in GA
Practice address
2040 Dan Proctor Dr Ste 140
Saint Marys, GA 31558-3812
Phone
(912) 576-6200
Fax
(912) 882-6411
NPI assigned
May 9, 2023
Last updated
Jul 9, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 113304 GA Primary

Addresses

Primary practice location

2040 Dan Proctor Dr Ste 140
Saint Marys, GA 31558-3812

Mailing address

2040 Dan Proctor Dr Ste 140
Saint Marys, GA 31558-3812

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Osteopathy

NPI Registry JSON

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

{
    "created_epoch": "1683590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783555200000",
    "number": "1396435756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2040 DAN PROCTOR DR STE 140",
            "city": "SAINT MARYS",
            "state": "GA",
            "postal_code": "315583812"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2040 DAN PROCTOR DR STE 140",
            "city": "SAINT MARYS",
            "state": "GA",
            "postal_code": "315583812",
            "telephone_number": "912-576-6200",
            "fax_number": "912-882-6411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GANN",
        "first_name": "CAITLIN",
        "middle_name": "LAZURICK",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-09",
        "last_updated": "2026-07-09",
        "certification_date": "2026-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "GA",
            "license": "113304",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Marys, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2026; 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.