NPIMap

Organization Active NPI

Hughston Clinic PC

  • Durable Medical Equipment & Medical Supplies
  • Leesburg, GA
National Provider Identifier
1699951897
Registry record updated Oct 25, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
HUGHSTON CLINIC PC
Practice address
117 Oakland Pkwy
Leesburg, GA 31763-7201
Phone
(706) 646-4371
Fax
(706) 646-4372
NPI assigned
Jan 17, 2008
Last updated
Oct 25, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2018

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

Authorized official

Name
Mr. Mark Baker
Title
Ceo
Phone
(706) 494-3290

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X NU Primary

Addresses

Primary practice location

117 Oakland Pkwy
Leesburg, GA 31763-7201

Mailing address

6262 Veterans Pkwy
Columbus, GA 31909-3540
Phone (706) 494-3193

Other names 1

  • The Hughston Clinic PC Former legal business name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100930020070 GA DME Supplier - Physician - General Practice 1355254780 Practice locations: Leesburg, GA

Other NPIs with the same Medicare PAC ID 15

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

View all 15

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1200528000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1540425600000",
    "number": "1699951897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6262 VETERANS PKWY",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319093540",
            "telephone_number": "706-494-3193",
            "fax_number": "706-494-3201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 OAKLAND PKWY",
            "city": "LEESBURG",
            "state": "GA",
            "postal_code": "317637201",
            "telephone_number": "706-646-4371",
            "fax_number": "706-646-4372"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HUGHSTON CLINIC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-17",
        "last_updated": "2018-10-25",
        "status": "A",
        "authorized_official_last_name": "BAKER",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "706-494-3290",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Hughston Clinic PC",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "The Hughston Clinic PC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Leesburg, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2018; 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.