Organization Active NPI

The Woman's Care Center

  • Obstetrics & Gynecology Physician
  • Milledgeville, GA
National Provider Identifier
1669572541
Registry record updated Nov 15, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
47654 Issued in GA
Legal business name
THE WOMAN'S CARE CENTER
Practice address
1001 Fernwood Dr
Milledgeville, GA 31061-5416
Phone
(478) 453-8100
Fax
(478) 453-8186
NPI assigned
Sep 22, 2006
Last updated
Nov 15, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2011

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

Authorized official

Name
Marisol San Inocencio, MDNPI 1831166081
Title
Owner
Phone
(478) 453-8100

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 Physician 207V00000X 47654 GA Primary

Addresses

Primary practice location

1001 Fernwood Dr
Milledgeville, GA 31061-5416

Mailing address

PO Box 669
Milledgeville, GA 31059-0669
Phone (478) 453-8100

Other identifiers 1

IdentifierTypeStateIssuer
000833566DMedicaidGA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060503000787 GA Part B Supplier - Clinic/Group Practice 3476563552 Receives reassigned benefits from 4 practitioners
Practice locations: Milledgeville, GA

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
11D0979516Woman's Care Center PC, the1001 Fernwood Drive, Milledgeville, GA 31061Certificate of waiverJan 11, 2027

National Provider Directory

National Provider Directory

Locations

1097 Lake Oconee Pkwy
#204
Eatonton, GA 31024
Phone (706) 485-0801

Practitioners & affiliated clinicians

Practitioners 4

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": "1158883200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1321315200000",
    "number": "1669572541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 669",
            "city": "MILLEDGEVILLE",
            "state": "GA",
            "postal_code": "310590669",
            "telephone_number": "478-453-8100",
            "fax_number": "478-453-8186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 FERNWOOD DR",
            "city": "MILLEDGEVILLE",
            "state": "GA",
            "postal_code": "310615416",
            "telephone_number": "478-453-8100",
            "fax_number": "478-453-8186"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE WOMAN'S CARE CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-22",
        "last_updated": "2011-11-15",
        "status": "A",
        "authorized_official_last_name": "SAN INOCENCIO",
        "authorized_official_first_name": "MARISOL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "478-453-8100",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "GA",
            "license": "47654",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000833566D",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Milledgeville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2011; 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.