NPIMap

Organization Active NPI

Southland Branch Family Practice, LLC

  • Family Nurse Practitioner
  • Americus, GA
National Provider Identifier
1700042553
Registry record updated Jul 31, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN127193 Issued in GA
Legal business name
SOUTHLAND BRANCH FAMILY PRACTICE, LLC
Practice address
151 Mayo St
Americus, GA 31709-3735
Phone
(229) 928-4144
Fax
(229) 928-3410
NPI assigned
Jul 31, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2008

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

Authorized official

Name
Denise C Laing
Title
Nurse Practioner
Phone
(229) 928-4144

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X RN127193 GA Primary

Addresses

Primary practice location

151 Mayo St
Americus, GA 31709-3735

Mailing address

PO Box 546
Americus, GA 31709-0546
Phone (229) 928-4144

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

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": "1217462400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1217462400000",
    "number": "1700042553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 546",
            "city": "AMERICUS",
            "state": "GA",
            "postal_code": "317090546",
            "telephone_number": "229-928-4144",
            "fax_number": "229-928-3410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "151 MAYO ST",
            "city": "AMERICUS",
            "state": "GA",
            "postal_code": "317093735",
            "telephone_number": "229-928-4144",
            "fax_number": "229-928-3410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHLAND BRANCH FAMILY PRACTICE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-31",
        "last_updated": "2008-07-31",
        "status": "A",
        "authorized_official_last_name": "LAING",
        "authorized_official_first_name": "DENISE",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "NURSE PRACTIONER",
        "authorized_official_telephone_number": "229-928-4144"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN127193",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Americus, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2008; 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.