NPIMap

Organization Active NPI

August University - Medical College of Georgia

  • Internal Medicine Physician
  • Augusta, GA
National Provider Identifier
1730865619
Registry record updated Jun 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
AUGUST UNIVERSITY - MEDICAL COLLEGE OF GEORGIA
Practice address
1120 15TH Street BL 5070
Augusta, GA 30912
Phone
(706) 721-2423
Fax
(706) 721-6918
NPI assigned
Jun 26, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2023

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

Authorized official

Name
Matthew J. Gold, DONPI 1023794906
Title
Resident Physician/Staff
Phone
(954) 729-1791

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

1120 15TH Street BL 5070
Augusta, GA 30912

Mailing address

1480 Wrightsboro Rd Unit 2201
Augusta, GA 30901
Phone (954) 729-1791

Other names 1

  • Augusta University Medical Center/Medical College of Georgia Other name

National Provider Directory

National Provider Directory

Locations

1120 15th St
#5070
Augusta, GA 30912
Phone (706) 721-2423

Practitioners & affiliated clinicians

Practitioners 53

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 53

NPI Registry JSON

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

{
    "created_epoch": "1687737600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1687737600000",
    "number": "1730865619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1480 WRIGHTSBORO RD UNIT 2201",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "30901",
            "telephone_number": "954-729-1791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1120 15TH STREET BL 5070",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "30912",
            "telephone_number": "706-721-2423",
            "fax_number": "706-721-6918"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AUGUST UNIVERSITY - MEDICAL COLLEGE OF GEORGIA",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-06-26",
        "last_updated": "2023-06-26",
        "certification_date": "2023-06-25",
        "status": "A",
        "authorized_official_last_name": "GOLD",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "RESIDENT PHYSICIAN/STAFF",
        "authorized_official_telephone_number": "954-729-1791",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Augusta University Medical Center/Medical College of Georgia",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Augusta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2023; 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.