Organization Active NPI

Middle Georgia OB/GYN,PC

  • Obstetrics & Gynecology Physician
  • Warner Robins, GA
National Provider Identifier
1669483889
Registry record updated Dec 17, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
050921 Issued in GA
Legal business name
MIDDLE GEORGIA OB/GYN,PC
Practice address
109 Osigian Blvd
Suite 400
Warner Robins, GA 31088-8925
Phone
(478) 333-6901
Fax
(478) 333-6907
NPI assigned
Aug 11, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2012

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

Authorized official

Name
Victoria A Shirley, DONPI 1316991888
Title
Owner
Phone
(478) 333-6901

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
Obstetrics & Gynecology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207V00000X 050921 GA Primary

Addresses

Primary practice location

109 Osigian Blvd
Suite 400
Warner Robins, GA 31088-8925

Mailing address

P O Box 8168
Warner Robins, GA 31095-8168
Phone (478) 333-6901

Other identifiers 1

IdentifierTypeStateIssuer
000960924BMedicaidGA

National Provider Directory

National Provider Directory

Locations

108 Featherstone Dr
Warner Robins, GA 31088
Phone (478) 313-5093

Practitioners & affiliated clinicians

Practitioners 1

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": "1155254400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1355702400000",
    "number": "1669483889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P O BOX 8168",
            "city": "WARNER ROBINS",
            "state": "GA",
            "postal_code": "310958168",
            "telephone_number": "478-333-6901",
            "fax_number": "478-333-6907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 OSIGIAN BLVD",
            "address_2": "SUITE 400",
            "city": "WARNER ROBINS",
            "state": "GA",
            "postal_code": "310888925",
            "telephone_number": "478-333-6901",
            "fax_number": "478-333-6907"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDDLE GEORGIA OB/GYN,PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-11",
        "last_updated": "2012-12-17",
        "status": "A",
        "authorized_official_last_name": "SHIRLEY",
        "authorized_official_first_name": "VICTORIA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "478-333-6901",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": "GA",
            "license": "050921",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000960924B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Warner Robins, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 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.