Mallory Andrew Lawrence, M.D.

Primary specialty

Colon & Rectal Surgery PhysicianTaxonomy code 208C00000X

License

026578 Issued in GA

Practice address

1348 Walton Way
Suite 6500
Augusta, GA 30901-5104

Phone

(706) 722-2118

Fax

(706) 722-0342

NPI assigned

Oct 23, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 6

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Beulah Grove Community Resource Center

  • Primary Care Clinic/Center
  • Augusta, GA
  • NPI 1558544684
  Medicare reassignment NPD

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

{
    "created_epoch": "1161561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1266192000000",
    "number": "1790868065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1348 WALTON WAY",
            "address_2": "SUITE 6500",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309015104",
            "telephone_number": "706-722-2118",
            "fax_number": "706-722-0342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1348 WALTON WAY",
            "address_2": "SUITE 6500",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309015104",
            "telephone_number": "706-722-2118",
            "fax_number": "706-722-0342"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAWRENCE",
        "first_name": "MALLORY",
        "middle_name": "ANDREW",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-23",
        "last_updated": "2010-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208C00000X",
            "taxonomy_group": "",
            "desc": "Colon & Rectal Surgery",
            "state": "GA",
            "license": "026578",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4140381",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "G26578",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00399517A",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "1621144003",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA HMO",
            "identifier": "2089751",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA HMO",
            "identifier": "1621144004",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cree Matthews Lause, P.T.
• William Edwin Lavigne, M.D.
• Lawc Counseling Services
• Latangie Lawlis, RBT
• Lawrence a Robillard MD PC
• Latasha Lawson-Fields, PHARMD
• Andrew Lawson, DO
• Angelique Raffinee Lawson, DNP, APRN, PMHNP-BC
• Jamie Wolf Lawson, D.O.
• Jazmine Lawson

• Colon & Rectal Surgery Physician in Augusta, GA
• Providers in Augusta, GA by specialty
• Colon & Rectal Surgery Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.