Individual provider Active NPI

Terriano Lashea Dobbs

  • Prosthetics Case Management
  • Macon, GA
National Provider Identifier
1417433798
Registry record updated Jul 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prosthetics Case ManagementTaxonomy code 1744P3200X
License
CO078512 Issued in GA
Practice address
3312 Northside Dr
Macon, GA 31210-2500
Phone
(478) 747-2027
NPI assigned
Jul 19, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 19, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Prosthetics Case Management 1744P3200X CO078512 GA Primary

Addresses

Primary practice location

3312 Northside Dr
Macon, GA 31210-2500

Mailing address

3312 Northside Dr
Macon, GA 31210-2500
Phone (478) 477-2682

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

State licenses

LicenseStateTypeSpecialty
CO078512GAMDProsthetics Case Management

NPI Registry JSON

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

{
    "created_epoch": "1531958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531958400000",
    "number": "1417433798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3312 NORTHSIDE DR",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312102500",
            "telephone_number": "478-477-2682"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3312 NORTHSIDE DR",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312102500",
            "telephone_number": "478-747-2027"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOBBS",
        "first_name": "TERRIANO",
        "middle_name": "LASHEA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-07-19",
        "last_updated": "2018-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1744P3200X",
            "taxonomy_group": "",
            "desc": "Specialist, Prosthetics Case Management",
            "state": "GA",
            "license": "CO078512",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Macon, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2018; 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.