NPIMap

Organization Active NPI

West Georgia Medical Center Inc

Doing business as West Georgia Health Michael D Myers MD

  • Urology Physician
  • Lagrange, GA
National Provider Identifier
1689985954
Registry record updated Feb 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
64613 Issued in GA
Legal business name
WEST GEORGIA MEDICAL CENTER INC
Doing business as
West Georgia Health Michael D Myers MD
Practice address
303 Medical Dr
Ste 406
Lagrange, GA 30240-4169
Phone
(706) 242-5201
Fax
(706) 242-5204
NPI assigned
Jul 1, 2010
Organization subpart
Yes
Parent organization
WEST GEORGIA MEDICAL CENTER INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 24, 2020

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

Authorized official

Name
Mr. Anthony J Budzinski
Title
Evp
Phone
(470) 644-0012

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208800000X 64613 GA Primary

Addresses

Primary practice location

303 Medical Dr
Ste 406
Lagrange, GA 30240-4169

Mailing address

1800 Parkway PL SE Ste 500
Marietta, GA 30067-8237
Phone (470) 956-4981

Other names 1

  • West Georgia Health Michael D Myers MD Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20091207000333 GA Part B Supplier - Clinic/Group Practice 9335286160 Receives reassigned benefits from 2 practitioners
3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Lagrange, GA

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Part of
West Georgia Medical Center Inc

NPI Registry JSON

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

{
    "created_epoch": "1277942400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1582502400000",
    "number": "1689985954",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 PARKWAY PL SE STE 500",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300678237",
            "telephone_number": "470-956-4981",
            "fax_number": "770-999-2489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303 MEDICAL DR",
            "address_2": "STE 406",
            "city": "LAGRANGE",
            "state": "GA",
            "postal_code": "302404169",
            "telephone_number": "706-242-5201",
            "fax_number": "706-242-5204"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST GEORGIA MEDICAL CENTER INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WEST GEORGIA MEDICAL CENTER INC",
        "enumeration_date": "2010-07-01",
        "last_updated": "2020-02-24",
        "certification_date": "2020-02-24",
        "status": "A",
        "authorized_official_last_name": "BUDZINSKI",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "EVP",
        "authorized_official_telephone_number": "470-644-0012",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Urology",
            "state": "GA",
            "license": "64613",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "West Georgia Health Michael D Myers MD",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "West Georgia Health Michael D Myers MD",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lagrange, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2020; 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.