NPIMap

Organization Active NPI

Medical Center, LLP

  • Primary Care Clinic/Center
  • Dublin, GA
National Provider Identifier
1790804268
Registry record updated Jul 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
MEDICAL CENTER, LLP
Doing business as
Medical Center, LLP
Practice address
908 Hillcrest Pkwy
Dublin, GA 31021-4206
Phone
(478) 272-7411
Fax
(478) 274-9809
NPI assigned
Mar 28, 2007
Last updated
Jul 3, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2022

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

Authorized official

Name
Dr. Andy F Williamson, M.D.NPI 1558354506
Title
Partner
Phone
(478) 272-7411

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
Primary Care Clinic/Center 261QP2300X Primary

Addresses

Primary practice location

908 Hillcrest Pkwy
Dublin, GA 31021-4206

Mailing address

908 Hillcrest Pkwy
Dublin, GA 31021-4206
Phone (478) 272-7411

Other identifiers 1

IdentifierTypeStateIssuer
85001427GMedicaidGA

Other names 1

  • Medical Center, LLP Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031110000345 GA Part B Supplier - Clinic/Group Practice 9133032774 Receives reassigned benefits from 14 practitioners
Practice locations: Dublin, GA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
11D0699024Medical Center, LLP, the908 Hillcrest Pkwy, Dublin, GA 31021ComplianceMar 12, 2027

National Provider Directory

National Provider Directory

Locations

1405 W Moore St
Dublin, GA 31021

Practitioners & affiliated clinicians

Practitioners 15

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 15

NPI Registry JSON

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

{
    "created_epoch": "1175040000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1656806400000",
    "number": "1790804268",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "908 HILLCREST PKWY",
            "city": "DUBLIN",
            "state": "GA",
            "postal_code": "310214206",
            "telephone_number": "478-272-7411",
            "fax_number": "478-274-9809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "908 HILLCREST PKWY",
            "city": "DUBLIN",
            "state": "GA",
            "postal_code": "310214206",
            "telephone_number": "478-272-7411",
            "fax_number": "478-274-9809"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL CENTER, LLP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-28",
        "last_updated": "2022-07-03",
        "certification_date": "2022-07-03",
        "status": "A",
        "authorized_official_last_name": "WILLIAMSON",
        "authorized_official_first_name": "ANDY",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "478-272-7411",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "85001427G",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Medical Center, LLP",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Medical Center, LLP",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Dublin, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.