Organization Active NPI

McDuffie Medical Associates, PC

  • Primary Care Clinic/Center
  • Thomson, GA
National Provider Identifier
1710037080
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
MCDUFFIE MEDICAL ASSOCIATES, PC
Practice address
505 Mount Pleasant Rd
Thomson, GA 30824-8140
Phone
(706) 595-1461
Fax
(706) 597-9824
NPI assigned
Jan 11, 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
Mrs. Pam Shivers
Title
Administrator
Phone
(706) 595-1461

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X Primary

Addresses

Primary practice location

505 Mount Pleasant Rd
Thomson, GA 30824-8140

Mailing address

PO Box 900
Thomson, GA 30824-0900
Phone (706) 595-1461

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040421000094 GA Part B Supplier - Clinic/Group Practice 6204822885 Receives reassigned benefits from 3 practitioners
Practice locations: Thomson, GA

National Provider Directory

National Provider Directory

Locations

505 Mount Pleasant Rd
Thomson, GA 30824
Phone (404) 595-1461

Practitioners & affiliated clinicians

Practitioners 7

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": "1168473600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1710037080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 900",
            "city": "THOMSON",
            "state": "GA",
            "postal_code": "308240900",
            "telephone_number": "706-595-1461",
            "fax_number": "706-597-9824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 MOUNT PLEASANT RD",
            "city": "THOMSON",
            "state": "GA",
            "postal_code": "308248140",
            "telephone_number": "706-595-1461",
            "fax_number": "706-597-9824"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MCDUFFIE MEDICAL ASSOCIATES, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-11",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SHIVERS",
        "authorized_official_first_name": "PAM",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "706-595-1461",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Thomson, 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 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.