NPIMap

Organization Active NPI

Gastroenterology Associates of Central Ga, LLC

  • Specialist
  • Macon, GA
National Provider Identifier
1528192176
Registry record updated Oct 6, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
GASTROENTEROLOGY ASSOCIATES OF CENTRAL GA, LLC
Practice address
610 3Rd St
Suite 206
Macon, GA 31201-3294
Phone
(478) 464-2600
Fax
(478) 464-2604
NPI assigned
Mar 15, 2007
Last updated
Oct 6, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2016

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

Authorized official

Name
Mrs. Angie Crouch
Title
Administrator
Phone
(478) 464-2600

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X NU Primary

Addresses

Primary practice location

610 3Rd St
Suite 206
Macon, GA 31201-3294

Mailing address

610 3Rd St
Suite 206
Macon, GA 31201-3294
Phone (478) 464-2600

Other identifiers 1

IdentifierTypeStateIssuer
DA4873OtherGAMEDICARE RAILRAOD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031209001042 GA Part B Supplier - Clinic/Group Practice 6901702059 Receives reassigned benefits from 25 practitioners
Practice locations: Gray, GA; Macon, GA; Milledgeville, GA

National Provider Directory

National Provider Directory

Member organizations 2

Organizations listed as members of this organization in the National Provider Directory.

Locations

904B Hillcrest Pkwy
Dublin, GA 31021
Phone (912) 537-4414

260 W Clinton St
Ste 3
Gray, GA 31032
Phone (478) 607-2514

310 Hospital Dr
Ste 305
Macon, GA 31217
Phone (478) 338-9200

610 3rd St
Ste 101
Macon, GA 31201

610 3rd St
Ste 104
Macon, GA 31201

610 3rd St
Ste 202
Macon, GA 31201
Phone (478) 216-7378

770 Pine St
Ste 270
Macon, GA 31201
Phone (478) 742-2474

Practitioners & affiliated clinicians

Practitioners 27

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 27

NPI Registry JSON

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

{
    "created_epoch": "1173916800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1475712000000",
    "number": "1528192176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "610 3RD ST",
            "address_2": "SUITE 206",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312013294",
            "telephone_number": "478-464-2600",
            "fax_number": "478-464-2604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "610 3RD ST",
            "address_2": "SUITE 206",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312013294",
            "telephone_number": "478-464-2600",
            "fax_number": "478-464-2604"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GASTROENTEROLOGY ASSOCIATES OF CENTRAL GA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-15",
        "last_updated": "2016-10-06",
        "status": "A",
        "authorized_official_last_name": "CROUCH",
        "authorized_official_first_name": "ANGIE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "478-464-2600",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILRAOD",
            "identifier": "DA4873",
            "state": "GA"
        }
    ],
    "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 Oct 6, 2016; 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.