NPIMap

Organization Active NPI

Columbus Cardiology Associates, PC

  • Interventional Cardiology Physician
  • Columbus, GA
National Provider Identifier
1407947625
Registry record updated Dec 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
Legal business name
COLUMBUS CARDIOLOGY ASSOCIATES, PC
Practice address
2300 Manchester Expy Ste 2001
Columbus, GA 31904-6877
Phone
(706) 323-5552
Fax
(706) 324-5695
NPI assigned
Sep 27, 2006
Last updated
Dec 10, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2024

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

Authorized official

Name
Gwen Johnson
Title
Practice Administrator
Phone
(706) 323-5552

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X
Interventional Cardiology Physician 207RI0011X Primary
Physician Assistant 363A00000X
Family Nurse Practitioner 363LF0000X

Addresses

Primary practice location

2300 Manchester Expy Ste 2001
Columbus, GA 31904-6877

Mailing address

2300 Manchester Expy Ste 2001
Columbus, GA 31904-6877
Phone (706) 323-5552

Other identifiers 3

IdentifierTypeStateIssuer
CL6888OtherGARAILROAD MEDICARE
300028277AMedicaidGA
529403690MedicaidAL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040416000141 GA Part B Supplier - Clinic/Group Practice 1557356995 Receives reassigned benefits from 17 practitioners
Practice locations: Columbus, GA

National Provider Directory

National Provider Directory

Locations

2300 Manchester Expy
Ste 1003
Columbus, GA 31904
Phone (706) 323-5552

2300 Manchester Expy
Ste 2001
Columbus, GA 31904
Phone (706) 323-5552

2525 Williams Rd
Columbus, GA 31909
Phone (706) 323-5552

Practitioners & affiliated clinicians

Practitioners 21

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 21

NPI Registry JSON

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

{
    "created_epoch": "1159315200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733788800000",
    "number": "1407947625",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2300 MANCHESTER EXPY STE 2001",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319046877",
            "telephone_number": "706-323-5552",
            "fax_number": "706-324-5695"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 MANCHESTER EXPY STE 2001",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319046877",
            "telephone_number": "706-323-5552",
            "fax_number": "706-324-5695"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLUMBUS CARDIOLOGY ASSOCIATES, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-27",
        "last_updated": "2024-12-10",
        "certification_date": "2024-12-10",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "GWEN",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "706-323-5552"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CL6888",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300028277A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "529403690",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2024; 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.