NPIMap

Organization Active NPI

Ergent Med Prime

  • Primary Care Clinic/Center
  • Brunswick, GA
National Provider Identifier
1811345390
Registry record updated May 25, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
ERGENT MED PRIME
Practice address
5248 New Jesup Hwy
Brunswick, GA 31523-1211
Phone
(912) 264-1883
NPI assigned
May 25, 2016
Last updated
May 25, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 25, 2016

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

Authorized official

Name
James R Cutia
Title
Owner/Partner
Phone
(912) 264-1883

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X NU Primary

Addresses

Primary practice location

5248 New Jesup Hwy
Brunswick, GA 31523-1211

Mailing address

5248 New Jesup Hwy
Brunswick, GA 31523-1211

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170925003644 GA Part B Supplier - Clinic/Group Practice 8820362189 Receives reassigned benefits from 8 practitioners
Practice locations: Brunswick, GA; St Simons Island, GA

National Provider Directory

National Provider Directory

Locations

106 Retreat Vlg
St Simons Island, GA 31522
Phone (912) 434-9316

Practitioners & affiliated clinicians

Practitioners 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1464134400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1464134400000",
    "number": "1811345390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5248 NEW JESUP HWY",
            "city": "BRUNSWICK",
            "state": "GA",
            "postal_code": "315231211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5248 NEW JESUP HWY",
            "city": "BRUNSWICK",
            "state": "GA",
            "postal_code": "315231211",
            "telephone_number": "912-264-1883"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ERGENT MED PRIME",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-25",
        "last_updated": "2016-05-25",
        "status": "A",
        "authorized_official_last_name": "CUTIA",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER/PARTNER",
        "authorized_official_telephone_number": "912-264-1883"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brunswick, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.