NPIMap

Organization Active NPI

Omar Queensbourrow

  • General Acute Care Hospital
  • Macon, GA
National Provider Identifier
1659625911
Registry record updated Nov 19, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
License
PA9106708 Issued in FL
Legal business name
OMAR QUEENSBOURROW
Practice address
305 Hospital Drive
Macon, GA 31217
Phone
(478) 746-4646
NPI assigned
Nov 7, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2012

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

Authorized official

Name
Omar Queensbourrow, PA
Title
Physician Assistant
Phone
(800) 507-8874

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X PA9106708 FL Primary

Addresses

Primary practice location

305 Hospital Drive
Macon, GA 31217

Mailing address

305 Hospital Drive
Apt 106
Macon, GA 31217
Phone (478) 746-4646

National Provider Directory

National Provider Directory
Tax ID family
Georgia Em-I Medical Service PC6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1352246400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1353283200000",
    "number": "1659625911",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "305 HOSPITAL DRIVE",
            "address_2": "APT 106",
            "city": "MACON",
            "state": "GA",
            "postal_code": "31217",
            "telephone_number": "478-746-4646"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 HOSPITAL DRIVE",
            "city": "MACON",
            "state": "GA",
            "postal_code": "31217",
            "telephone_number": "478-746-4646"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OMAR QUEENSBOURROW",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-11-07",
        "last_updated": "2012-11-19",
        "status": "A",
        "authorized_official_last_name": "QUEENSBOURROW",
        "authorized_official_first_name": "OMAR",
        "authorized_official_title_or_position": "PHYSICIAN ASSISTANT",
        "authorized_official_telephone_number": "800-507-8874",
        "authorized_official_credential": "PA"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "FL",
            "license": "PA9106708",
            "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 Nov 19, 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.