NPIMap

Organization Active NPI

Middle Georgia Gastroenterology

  • Specialist
  • Macon, GA
National Provider Identifier
1689885253
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
MIDDLE GEORGIA GASTROENTEROLOGY
Practice address
791 Poplar St
Macon, GA 31201-2045
Phone
(478) 755-0800
Fax
(478) 755-0807
NPI assigned
May 25, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Carley S Ebanks, M.D.
Title
President
Phone
(478) 755-0800

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X Primary

Addresses

Primary practice location

791 Poplar St
Macon, GA 31201-2045

Mailing address

791 Poplar St
Macon, GA 31201-2045
Phone (478) 755-0800

National Provider Directory

National Provider Directory

Locations

791 Poplar St
Macon, GA 31201
Phone (478) 755-0800

Practitioners & affiliated clinicians

Practitioners 9

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": "1180051200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1689885253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "791 POPLAR ST",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312012045",
            "telephone_number": "478-755-0800",
            "fax_number": "478-755-0807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "791 POPLAR ST",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312012045",
            "telephone_number": "478-755-0800",
            "fax_number": "478-755-0807"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDDLE GEORGIA GASTROENTEROLOGY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-25",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "EBANKS",
        "authorized_official_first_name": "CARLEY",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "478-755-0800",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Macon, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.