NPIMap

Organization Active NPI

Correctiona Medical Associates

  • Clinic/Center
  • Fayetteville, GA
National Provider Identifier
1407017965
Registry record updated Jun 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
RN113001 Issued in GA
Legal business name
CORRECTIONA MEDICAL ASSOCIATES
Practice address
205 McIntosh Place Dr
Fayetteville, GA 30214-7384
Phone
(770) 719-3319
NPI assigned
Jun 18, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2008

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

Authorized official

Name
Dr. Marcus Moseley, M.D
Title
Chief Medical Officer
Phone
(404) 853-2097

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X RN113001 GA Primary

Addresses

Primary practice location

205 McIntosh Place Dr
Fayetteville, GA 30214-7384

Mailing address

205 McIntosh Place Dr
Fayetteville, GA 30214-7384
Phone (770) 719-3319

National Provider Directory

National Provider Directory
Tax ID family
Correctiona Medical Associates2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

NPI Registry JSON

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

{
    "created_epoch": "1213747200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213747200000",
    "number": "1407017965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 MCINTOSH PLACE DR",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302147384",
            "telephone_number": "770-719-3319"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 MCINTOSH PLACE DR",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302147384",
            "telephone_number": "770-719-3319"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORRECTIONA MEDICAL ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-18",
        "last_updated": "2008-06-18",
        "status": "A",
        "authorized_official_last_name": "MOSELEY",
        "authorized_official_first_name": "MARCUS",
        "authorized_official_title_or_position": "CHIEF MEDICAL OFFICER",
        "authorized_official_telephone_number": "404-853-2097",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "GA",
            "license": "RN113001",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2008; 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.