NPIMap

Organization Active NPI

Family Practice Healthcare Clinic/Urgent Care Clinic, LLC

  • Urgent Care Clinic/Center
  • McRae, GA
National Provider Identifier
1487022646
Registry record updated Sep 4, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urgent Care Clinic/CenterTaxonomy code 261QU0200X
License
037111GA Issued in GA
Legal business name
FAMILY PRACTICE HEALTHCARE CLINIC/URGENT CARE CLINIC, LLC
Practice address
10 North 3Rd Avenue
McRae, GA 31055
Phone
(229) 868-2831
NPI assigned
Sep 4, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2015

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

Authorized official

Name
Dr. Edmund Matthew Wright, M.D.
Title
Phycian/Owner
Phone
(229) 868-2831

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urgent Care Clinic/Center 261QU0200X 037111GA GA Primary

Addresses

Primary practice location

10 North 3Rd Avenue
McRae, GA 31055

Mailing address

10 North 3Rd Avenue
McRae, GA 31055
Phone (229) 868-2831

Other identifiers 2

IdentifierTypeStateIssuer
202G086558OtherMEDICARE
522838074AMedicaidGA

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1441324800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1441324800000",
    "number": "1487022646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 NORTH 3RD AVENUE",
            "city": "MCRAE",
            "state": "GA",
            "postal_code": "31055",
            "telephone_number": "229-868-2831"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 NORTH 3RD AVENUE",
            "city": "MCRAE",
            "state": "GA",
            "postal_code": "31055",
            "telephone_number": "229-868-2831"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY PRACTICE HEALTHCARE CLINIC/URGENT CARE CLINIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-04",
        "last_updated": "2015-09-04",
        "status": "A",
        "authorized_official_last_name": "WRIGHT",
        "authorized_official_first_name": "EDMUND",
        "authorized_official_middle_name": "MATTHEW",
        "authorized_official_title_or_position": "PHYCIAN/OWNER",
        "authorized_official_telephone_number": "229-868-2831",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": "GA",
            "license": "037111GA",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "202G086558",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "522838074A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in McRae, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2015; 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.