Coosa Medical Group

Primary specialty

SpecialistTaxonomy code 174400000X

Legal business name

COOSA MEDICAL GROUP

Practice address

126 Three Rivers Dr NE
Rome, GA 30161-4999

Phone

(706) 295-0070

Fax

(706) 235-1618

NPI assigned

May 4, 2006

Organization subpart

No

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

Authorized official

Name

Mrs. Nancy C Smith

Title

Office Manager

Phone

(706) 238-5465

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• William K Naguszewski, M.D.

  • Neurology Physician
  • Rome, GA
  • NPI 1134103997
  Medicare reassignment NPD

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

{
    "created_epoch": "1146700800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1821046863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "126 THREE RIVERS DR NE",
            "city": "ROME",
            "state": "GA",
            "postal_code": "301614999",
            "telephone_number": "706-295-0070",
            "fax_number": "706-235-1618"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "126 THREE RIVERS DR NE",
            "city": "ROME",
            "state": "GA",
            "postal_code": "301614999",
            "telephone_number": "706-295-0070",
            "fax_number": "706-235-1618"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COOSA MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-04",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "NANCY",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "706-238-5465",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "GA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300029189C",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE GROUP#",
            "identifier": "CG3794",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300029189A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Toshica Conyers
• Kimberly Erin Cook, NP-C
• Zachary Alan Cook, DO
• Vickie Cooper, RN
• Coosa Eye Clinic, Inc
• Coosa Neurology PC
• Coosa Neurosurgery PC
• Coosa Procedure Center LLC
• Coosa Valley Chiropractic, LLC
• Coosa Valley Regional Services

• Specialist in Rome, GA
• Providers in Rome, GA by specialty
• Specialist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.