NPIMap

Organization Active NPI

Augusta Plastic Surgery Associates

  • Plastic Surgery Physician
  • Martinez, GA
National Provider Identifier
1649229584
Registry record updated Jul 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
Legal business name
AUGUSTA PLASTIC SURGERY ASSOCIATES
Practice address
569 Furys Ferry Rd
Martinez, GA 30907-9059
Phone
(706) 724-5611
Fax
(706) 724-5435
NPI assigned
May 9, 2006
Last updated
Jul 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2020

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

Authorized official

Name
Mrs. Charon P Bartley
Title
Billing Manager
Phone
(706) 724-5611

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery Physician 208200000X Primary

Addresses

Primary practice location

569 Furys Ferry Rd
Martinez, GA 30907-9059

Mailing address

569 Furys Ferry Rd
Martinez, GA 30907-9059
Phone (706) 724-5611

Other identifiers 2

IdentifierTypeStateIssuer
300022627AMedicaidGA
GPA860MedicaidSC

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031104000646 GA Part B Supplier - Clinic/Group Practice 3779495064 Receives reassigned benefits from 2 practitioners
Practice locations: Martinez, GA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 6

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": "1147132800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1595376000000",
    "number": "1649229584",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "569 FURYS FERRY RD",
            "city": "MARTINEZ",
            "state": "GA",
            "postal_code": "309079059",
            "telephone_number": "706-724-5611",
            "fax_number": "706-724-5435"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "569 FURYS FERRY RD",
            "city": "MARTINEZ",
            "state": "GA",
            "postal_code": "309079059",
            "telephone_number": "706-724-5611",
            "fax_number": "706-724-5435"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AUGUSTA PLASTIC SURGERY ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-09",
        "last_updated": "2020-07-22",
        "certification_date": "2020-07-22",
        "status": "A",
        "authorized_official_last_name": "BARTLEY",
        "authorized_official_first_name": "CHARON",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "706-724-5611",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300022627A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GPA860",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Martinez, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2020; 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.