Individual provider Active NPI

Carlos Enrique Layne, PA-C

  • Surgical Physician Assistant
  • Augusta, GA
National Provider Identifier
1760490478
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
002585 Issued in GA
Practice address
1 Freedom Way
Augusta, GA 30904-6258
Phone
(706) 733-0188
Fax
(706) 823-3939
NPI assigned
Aug 4, 2006
Sex
Male
Sole proprietor
No

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
002585GAMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Augusta University Past Accepting new patients
Athens-Clarke Emergency Specialists Past Accepting new patients

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 002585 GA Primary

Addresses

NPPES NPI Registry

Primary practice location

1 Freedom Way
Augusta, GA 30904-6258

Mailing address

181 Kestwick Dr W
Martinez, GA 30907-1687
Phone (706) 860-9591

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 8, 2007.

{
    "created_epoch": "1154649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1760490478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "181 KESTWICK DR W",
            "city": "MARTINEZ",
            "state": "GA",
            "postal_code": "309071687",
            "telephone_number": "706-860-9591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 FREEDOM WAY",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309046258",
            "telephone_number": "706-733-0188",
            "fax_number": "706-823-3939"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAYNE",
        "first_name": "CARLOS",
        "middle_name": "ENRIQUE",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "GA",
            "license": "002585",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Jul 8, 2007; 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.