NPIMap

Organization Active NPI

Archbold Medical Group, Inc.

Doing business as Archbold Medical Group

  • General Practice Physician
  • Thomasville, GA
National Provider Identifier
1508132887
Registry record updated Jul 2, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
ARCHBOLD MEDICAL GROUP, INC.
Doing business as
Archbold Medical Group
Practice address
2621 E Pinetree Blvd
Thomasville, GA 31792-4840
Phone
(229) 226-5788
Fax
(229) 226-2548
NPI assigned
Mar 30, 2012
Last updated
Jul 2, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2014

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

Authorized official

Name
Mr. Charles D Hightower
Title
Senior VP/Cfo
Phone
(229) 228-2853

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X NU Primary

Addresses

Primary practice location

2621 E Pinetree Blvd
Thomasville, GA 31792-4840

Mailing address

900 Cairo Rd
Thomasville, GA 31792-4255

Other names 1

  • Archbold Medical Group Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20081001000632 GA Part B Supplier - Clinic/Group Practice 8123196383 Receives reassigned benefits from 103 practitioners
4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Thomasville, GA; Whigham, GA; Bainbridge, GA; Cairo, GA; Camilla, GA; Moultrie, GA; Pelham, GA; Quitman, GA

Other NPIs on the same Medicare enrollment 4

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1333065600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1404259200000",
    "number": "1508132887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 CAIRO RD",
            "city": "THOMASVILLE",
            "state": "GA",
            "postal_code": "317924255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2621 E PINETREE BLVD",
            "city": "THOMASVILLE",
            "state": "GA",
            "postal_code": "317924840",
            "telephone_number": "229-226-5788",
            "fax_number": "229-226-2548"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ARCHBOLD MEDICAL GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-30",
        "last_updated": "2014-07-02",
        "status": "A",
        "authorized_official_last_name": "HIGHTOWER",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "SENIOR VP/CFO",
        "authorized_official_telephone_number": "229-228-2853",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Archbold Medical Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Thomasville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2014; 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.