NPIMap

Organization Active NPI

Astoria of Middle Ga LLC

  • Anesthesiology Physician
  • Macon, GA
National Provider Identifier
1609140870
Registry record updated Jun 8, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
ASTORIA OF MIDDLE GA LLC
Practice address
403 Lakeview PL
Macon, GA 31211-6127
Phone
(478) 787-9153
NPI assigned
Mar 5, 2012
Last updated
Jun 8, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2012

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

Authorized official

Name
Mr. William Enrique Agudelo, CRNA
Title
President
Phone
(478) 787-9153

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X Primary

Addresses

Primary practice location

403 Lakeview PL
Macon, GA 31211-6127

Mailing address

403 Lakeview PL
Macon, GA 31211-6127
Phone (478) 787-9153

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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": "1330905600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1339113600000",
    "number": "1609140870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "403 LAKEVIEW PL",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312116127",
            "telephone_number": "478-787-9153"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "403 LAKEVIEW PL",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312116127",
            "telephone_number": "478-787-9153"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ASTORIA OF MIDDLE GA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-05",
        "last_updated": "2012-06-08",
        "status": "A",
        "authorized_official_last_name": "AGUDELO",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "ENRIQUE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "478-787-9153",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CRNA"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "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 Jun 8, 2012; 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.