Total Healthcare of Lagrange, LLC

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

Legal business name

TOTAL HEALTHCARE OF LAGRANGE, LLC

Practice address

3452 Hogansville Rd
Suite B
Lagrange, GA 30241-8269

Phone

(706) 302-3097

Fax

(866) 571-7675

NPI assigned

Apr 19, 2012

Organization subpart

No

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

Authorized official

Name

Mr. Christopher Smith, OWNER

Title

Owner

Phone

(706) 594-1346

Specialties & licenses 6

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1334793600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1421712000000",
    "number": "1740547447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3452 HOGANSVILLE RD",
            "address_2": "SUITE B",
            "city": "LAGRANGE",
            "state": "GA",
            "postal_code": "302418269",
            "telephone_number": "706-302-3097",
            "fax_number": "866-571-7675"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3452 HOGANSVILLE RD",
            "address_2": "SUITE B",
            "city": "LAGRANGE",
            "state": "GA",
            "postal_code": "302418269",
            "telephone_number": "706-302-3097",
            "fax_number": "866-571-7675"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TOTAL HEALTHCARE OF LAGRANGE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-19",
        "last_updated": "2015-01-20",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "706-594-1346",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "OWNER"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "GA",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "GA",
            "license": null,
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "VIBK5UHI",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• General Practice Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2015; 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.