Coliseum Primary Care Services, LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

COLISEUM PRIMARY CARE SERVICES, LLC

Doing business as

Coliseum Medical Group-Northside

Practice address

380 Hospital Dr
BLDG a Suite 370
Macon, GA 31217-8001

Phone

(478) 474-4343

Fax

(844) 664-2283

NPI assigned

Jun 7, 2006

Last updated

Nov 1, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Kristine Turner

Title

Controller

Phone

(843) 856-7938

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Coliseum Medical Group-Northside Doing business as

Locations

Practitioners 1

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.

• Clayton Seigel, MD

  • Internal Medicine Physician
  • Macon, GA
  • NPI 1023634409
  NPD (past)

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

{
    "created_epoch": "1149638400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1477958400000",
    "number": "1629018023",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 403570",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303843570",
            "telephone_number": "478-474-4343",
            "fax_number": "844-664-2283"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "380 HOSPITAL DR",
            "address_2": "BLDG A SUITE 370",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312178001",
            "telephone_number": "478-474-4343",
            "fax_number": "844-664-2283"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLISEUM PRIMARY CARE SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-07",
        "last_updated": "2016-11-01",
        "status": "A",
        "authorized_official_last_name": "TURNER",
        "authorized_official_first_name": "KRISTINE",
        "authorized_official_title_or_position": "CONTROLLER",
        "authorized_official_telephone_number": "843-856-7938"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DE1497",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "195942266A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Coliseum Medical Group-Northside",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Coliseum Medical Center, LLC (Piedmont Macon Medical Center)
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• Coliseum Medical Center, LLC (Piedmont Macon Medical Center)
• Coliseum Park Cancer Treatment Center
• Coliseum Pediatric and Adolescent Care, Inc
• Coliseum Same Day Surgery Center LP
• April Nicole Colley, CPNP
• Collier B. Gladin, Jr., M.D., LLC (Collier B Gladin Jr MD)
• Deborah Lusendia Collier, FNP-C
• Samuel Scott Collier, NP

• Internal Medicine Physician in Macon, GA
• Providers in Macon, GA by specialty
• Internal Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2016; 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.