NPIMap

Organization Active NPI

Phoebe Putney Memorial Hospital

  • Clinical Medical Laboratory
  • Albany, GA
National Provider Identifier
1699773077
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
License
047-003 Issued in GA
Legal business name
PHOEBE PUTNEY MEMORIAL HOSPITAL
Practice address
417 W 3Rd Ave
Laboratory
Albany, GA 31701-1943
Phone
(229) 312-6198
Fax
(229) 312-6105
NPI assigned
Jul 11, 2005
Last updated
Aug 22, 2020By the provider in NPPES
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
Mr. Kerry Loudermilk
Title
Cfo
Phone
(229) 312-4068

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X 047-003 GA Primary

Addresses

Primary practice location

417 W 3Rd Ave
Laboratory
Albany, GA 31701-1943

Mailing address

417 W 3Rd Ave
Albany, GA 31701-1943
Phone (229) 312-6198

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
11D0646144Phoebe Putney Memorial Hospital417 W Third Avenue, Albany, GA 31701AccreditationJun 6, 2027

National Provider Directory

National Provider Directory
Tax ID family
Phoebe Putney Memorial Hospital30 organizations share this tax ID, including this one

Other organizations with this tax ID 29

Organizations that report the same tax identification number in the National Provider Directory.

View all 29

Practitioners & affiliated clinicians

Practitioners 1

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": "1121040000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1699773077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "417 W 3RD AVE",
            "city": "ALBANY",
            "state": "GA",
            "postal_code": "317011943",
            "telephone_number": "229-312-6198",
            "fax_number": "229-312-6105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "417 W 3RD AVE",
            "address_2": "LABORATORY",
            "city": "ALBANY",
            "state": "GA",
            "postal_code": "317011943",
            "telephone_number": "229-312-6198",
            "fax_number": "229-312-6105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHOEBE PUTNEY MEMORIAL HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-11",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "LOUDERMILK",
        "authorized_official_first_name": "KERRY",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "229-312-4068",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "GA",
            "license": "047-003",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albany, 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.
  • 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.