Family Practice Healthcare Clinic/ Urgent Care

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

037111 Issued in GA

Legal business name

FAMILY PRACTICE HEALTHCARE CLINIC/ URGENT CARE

Practice address

10 North 3Rd Ave
McRae, GA 31055-4941

Phone

(229) 868-2831

Fax

(229) 520-3068

NPI assigned

Jun 30, 2009

Last updated

Mar 28, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Edmund Matt Wright Sr., MD

Title

MD

Phone

(229) 868-2831

Specialties & licenses 4

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1246320000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1332892800000",
    "number": "1689802597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 NORTH 3RD AVE",
            "city": "MCRAE",
            "state": "GA",
            "postal_code": "310554941",
            "telephone_number": "229-868-2831",
            "fax_number": "229-520-3068"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 NORTH 3RD AVE",
            "city": "MCRAE",
            "state": "GA",
            "postal_code": "310554941",
            "telephone_number": "229-868-2831",
            "fax_number": "229-520-3068"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY PRACTICE HEALTHCARE CLINIC/ URGENT CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-30",
        "last_updated": "2012-03-28",
        "status": "A",
        "authorized_official_last_name": "WRIGHT",
        "authorized_official_first_name": "EDMUND",
        "authorized_official_middle_name": "MATT",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "229-868-2831",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Sr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "GA",
            "license": "RN115997",
            "primary": false
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "GA",
            "license": "037111",
            "primary": true
        },
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": "GA",
            "license": "RN115997",
            "primary": false
        },
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": "GA",
            "license": "037111",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "RN115997",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000539283J",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kelly Hamilton Deloach, MPT
• Casey Dix, NP
• Megan Deanna Dowdy, PTA
• Dr. Griffin E. Mizell D.D.S
• Clayton Kyle Ellis, PTA
• Family Practice Healthcare Clinic/Urgent Care Clinic, LLC
• Golden Isles Healthcare,LLC
• Rebecca Knowles Greene, FNP-C
• Habigaile Cribe, MD LLC
• Angela J Hardy, PA

• Primary Care Clinic/Center in McRae, GA
• Providers in McRae, GA by specialty
• Primary Care Clinic/Center in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 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.