NPIMap

Organization Active NPI

Augusta ENT PC

  • Otolaryngology Physician
  • Aiken, SC
National Provider Identifier
1679945661
Registry record updated Oct 30, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
Legal business name
AUGUSTA ENT PC
Practice address
74 Physician Dr
Aiken, SC 29801-6388
Phone
(706) 868-5676
Fax
(706) 722-2824
NPI assigned
Oct 29, 2015
Last updated
Oct 30, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2015

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

Authorized official

Name
Keith A Lynn
Title
Ceo
Phone
(706) 868-5676

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Y00000X Primary

Addresses

Primary practice location

74 Physician Dr
Aiken, SC 29801-6388

Mailing address

340 N Belair Rd
Evans, GA 30809-3000
Phone (706) 868-5676

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20151211001453 SC Part B Supplier - Clinic/Group Practice 9537156484 Receives reassigned benefits from 10 practitioners
Practice locations: Aiken, SC

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory

Locations

4975 Gateway Blvd
Grovetown, GA 30813

170 University Pkwy
Aiken, SC 29801
Phone (803) 649-9975

Practitioners & affiliated clinicians

Practitioners 32

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 32

NPI Registry JSON

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

{
    "created_epoch": "1446076800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1446163200000",
    "number": "1679945661",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "340 N BELAIR RD",
            "city": "EVANS",
            "state": "GA",
            "postal_code": "308093000",
            "telephone_number": "706-868-5676",
            "fax_number": "706-722-2824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "74 PHYSICIAN DR",
            "city": "AIKEN",
            "state": "SC",
            "postal_code": "298016388",
            "telephone_number": "706-868-5676",
            "fax_number": "706-722-2824"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AUGUSTA ENT PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-29",
        "last_updated": "2015-10-30",
        "status": "A",
        "authorized_official_last_name": "LYNN",
        "authorized_official_first_name": "KEITH",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "706-868-5676"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Otolaryngology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aiken, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2015; 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.