NPIMap

Organization Active NPI

DMC Physician Group LLC

Doing business as Abbeville Primary Care

  • Rural Health Clinic/Center
  • Abbeville, GA
National Provider Identifier
1750955142
Registry record updated May 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
DMC PHYSICIAN GROUP LLC
Doing business as
Abbeville Primary Care
Practice address
417 Broad St S
Abbeville, GA 31001-4305
Phone
(229) 467-3209
Fax
(229) 467-3212
NPI assigned
May 19, 2021
Last updated
May 19, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 19, 2021

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

Authorized official

Name
Paige Wynn
Title
Ceo
Phone
(229) 424-7100

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU
Rural Health Clinic/Center 261QR1300X NU Primary

Addresses

Primary practice location

417 Broad St S
Abbeville, GA 31001-4305

Mailing address

117 Kite Rd
Swainsboro, GA 30401-3231
Phone (478) 289-1100

Other names 1

  • ABBEVILLE PRIMARY CARE Doing business as

National Provider Directory

National Provider Directory
Tax ID family
DMC Physician Group LLC9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1621382400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1621382400000",
    "number": "1750955142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 KITE RD",
            "city": "SWAINSBORO",
            "state": "GA",
            "postal_code": "304013231",
            "telephone_number": "478-289-1100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "417 BROAD ST S",
            "city": "ABBEVILLE",
            "state": "GA",
            "postal_code": "310014305",
            "telephone_number": "229-467-3209",
            "fax_number": "229-467-3212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DMC PHYSICIAN GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-19",
        "last_updated": "2021-05-19",
        "certification_date": "2021-04-26",
        "status": "A",
        "authorized_official_last_name": "WYNN",
        "authorized_official_first_name": "PAIGE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "229-424-7100"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ABBEVILLE PRIMARY CARE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Abbeville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2021; 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.