NPIMap

Organization Active NPI

Phoebe Radiology

  • Diagnostic Radiology Physician
  • Albany, GA
National Provider Identifier
1710147210
Registry record updated Jun 10, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
PHOEBE RADIOLOGY
Practice address
417 W 3Rd Ave
Albany, GA 31701-1943
Phone
(229) 312-5800
Fax
(229) 312-5853
NPI assigned
Jun 10, 2008
Organization subpart
Yes
Parent organization
PHOEBE PUTNEY MEMORIAL HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 10, 2008

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

Authorized official

Name
Frank M Middleton III, MD
Title
Senior VP
Phone
(229) 312-1000

Specialties & licenses 8

Specialty (taxonomy)CodeLicenseStatePrimary
Body Imaging PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2085B0100X
Diagnostic Neuroimaging (Radiology) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2085D0003X
Neuroradiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2085N0700X
Nuclear Radiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2085N0904X
Radiation Oncology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2085R0001X
Diagnostic Radiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2085R0202X Primary
Vascular & Interventional Radiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2085R0204X
Diagnostic Ultrasound PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2085U0001X

Addresses

Primary practice location

417 W 3Rd Ave
Albany, GA 31701-1943

Mailing address

PO Box 2548
Albany, GA 31702-2548
Phone (229) 312-5800

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031203000397 GA Part B Supplier - Clinic/Group Practice 4486559549 Receives reassigned benefits from 272 practitioners
5 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Albany, GA; Americus, GA; Atlanta, GA; Camilla, GA; Cordele, GA; Fitzgerald, GA; Leesburg, GA; Moultrie, GA…

Other NPIs on the same Medicare enrollment 5

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

National Provider Directory

National Provider Directory
Part of
Phoebe Putney Memorial Hospital

Practitioners & affiliated clinicians

Practitioners 16

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.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1213056000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213056000000",
    "number": "1710147210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2548",
            "city": "ALBANY",
            "state": "GA",
            "postal_code": "317022548",
            "telephone_number": "229-312-5800",
            "fax_number": "229-312-5853"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "417 W 3RD AVE",
            "city": "ALBANY",
            "state": "GA",
            "postal_code": "317011943",
            "telephone_number": "229-312-5800",
            "fax_number": "229-312-5853"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHOEBE RADIOLOGY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PHOEBE PUTNEY MEMORIAL HOSPITAL",
        "enumeration_date": "2008-06-10",
        "last_updated": "2008-06-10",
        "status": "A",
        "authorized_official_last_name": "MIDDLETON",
        "authorized_official_first_name": "FRANK",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "SENIOR VP",
        "authorized_official_telephone_number": "229-312-1000",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2085B0100X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Body Imaging",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085D0003X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Neuroimaging",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085N0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Neuroradiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085N0904X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Nuclear Radiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Radiation Oncology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085U0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Ultrasound",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "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 Jun 10, 2008; 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.