NPIMap

Organization Active NPI

Port City Medical Associates Inc

  • Methadone Clinic
  • Bainbridge, GA
National Provider Identifier
1669088795
Registry record updated Sep 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Methadone ClinicTaxonomy code 261QM2800X
Legal business name
PORT CITY MEDICAL ASSOCIATES INC
Practice address
931 S West St
Bainbridge, GA 39819-4543
Phone
(229) 248-4220
NPI assigned
Sep 23, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2020

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

Authorized official

Name
Mr. Edward ReynoldsNPI 1265007504
Title
President
Phone
(229) 246-7200

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Methadone Clinic 261QM2800X Primary

Addresses

Primary practice location

931 S West St
Bainbridge, GA 39819-4543

Mailing address

PO Box 576
Bainbridge, GA 39818-0576

Other names 2

  • Bainbridge Treatment Center Doing business as
  • City of Bainbridge Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Opioid treatment program
Medicare-enrolled since Dec 23, 2024

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250407001074 GA Part B Supplier - Opioid Treatment Program (Otp) 8426572934 Practice locations: Bainbridge, GA

National Provider Directory

National Provider Directory

Locations

931 S West St
Bainbridge, GA 39819
Phone (229) 248-4220

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1600819200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1600819200000",
    "number": "1669088795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 576",
            "city": "BAINBRIDGE",
            "state": "GA",
            "postal_code": "398180576"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "931 S WEST ST",
            "city": "BAINBRIDGE",
            "state": "GA",
            "postal_code": "398194543",
            "telephone_number": "229-248-4220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PORT CITY MEDICAL ASSOCIATES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-23",
        "last_updated": "2020-09-23",
        "certification_date": "2020-09-23",
        "status": "A",
        "authorized_official_last_name": "REYNOLDS",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "229-246-7200",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QM2800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Methadone",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bainbridge Treatment Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "City of Bainbridge",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bainbridge, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 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.