NPIMap

Organization Active NPI

Phoebe Gastroenterology Associates

  • Clinic/Center
  • Albany, GA
National Provider Identifier
1659627131
Registry record updated Aug 2, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
PHOEBE GASTROENTEROLOGY ASSOCIATES
Practice address
2740 Ray Knight Way
Ste 100
Albany, GA 31707-0226
Phone
(229) 312-0669
NPI assigned
Aug 2, 2012
Last updated
Aug 2, 2012By the provider in NPPES
Organization subpart
Yes
Parent organization
PHOEBE PHYSICIAN GROUP INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 2, 2012

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

Authorized official

Name
Robert Lagesse
Title
Sr VP Physician Services
Phone
(229) 312-1000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

2740 Ray Knight Way
Ste 100
Albany, GA 31707-0226

Mailing address

2740 Ray Knight Way
Ste 100
Albany, GA 31707-0226
Phone (229) 312-0669

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090121000583 GA Part B Supplier - Clinic/Group Practice 8426112350 Receives reassigned benefits from 1,136 practitioners
14 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment

Other NPIs on the same Medicare enrollment 14

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 14

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
11D1095022Phoebe Gastroenterology Associates2740 Ray Knight Way, Suite 100, Albany, GA 31707Certificate of waiverFeb 1, 2027

National Provider Directory

National Provider Directory
Tax ID family
Sumter Specialty Medicine26 organizations share this tax ID, including this one
Part of
Sumter Specialty Medicine

Other organizations with this tax ID 25

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

View all 25

Locations

2740 Ray Knight Way
Ste 100
Albany, GA 31707
Phone (229) 312-0698

Practitioners & affiliated clinicians

Practitioners 26

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 26

NPI Registry JSON

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

{
    "created_epoch": "1343865600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1343865600000",
    "number": "1659627131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2740 RAY KNIGHT WAY",
            "address_2": "STE 100",
            "city": "ALBANY",
            "state": "GA",
            "postal_code": "317070226",
            "telephone_number": "229-312-0669"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2740 RAY KNIGHT WAY",
            "address_2": "STE 100",
            "city": "ALBANY",
            "state": "GA",
            "postal_code": "317070226",
            "telephone_number": "229-312-0669"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHOEBE GASTROENTEROLOGY ASSOCIATES",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PHOEBE PHYSICIAN GROUP INC",
        "enumeration_date": "2012-08-02",
        "last_updated": "2012-08-02",
        "status": "A",
        "authorized_official_last_name": "LAGESSE",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "SR VP PHYSICIAN SERVICES",
        "authorized_official_telephone_number": "229-312-1000"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albany, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.