NPIMap

Organization Active NPI

Phoebe Putney Memorial Hospital, Inc.

Doing business as Phoebe Family Medical Center - Pelham

  • Rural Health Clinic/Center
  • Pelham, GA
National Provider Identifier
1821239765
Registry record updated Feb 11, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
PHOEBE PUTNEY MEMORIAL HOSPITAL, INC.
Doing business as
Phoebe Family Medical Center - Pelham
Practice address
410 Curry St NE
Pelham, GA 31779-1457
Phone
(229) 294-9233
NPI assigned
Mar 23, 2009
Last updated
Feb 11, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2014

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

Authorized official

Name
Robert Lagesse
Title
Sr VP Physician Services
Phone
(229) 312-1000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X GA Primary

Addresses

Primary practice location

410 Curry St NE
Pelham, GA 31779-1457

Mailing address

PO Box 3109
Albany, GA 31706-3109
Phone (229) 294-9233

Other names 1

  • Phoebe Family Medical Center - Pelham Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20031202000200 GA Part B Supplier - Clinic/Group Practice 4486559549 Receives reassigned benefits from 2 practitioners
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Albany, GA; Pelham, GA; Dawson, GA; Arlington, GA; Camilla, GA
O20031203000397 GA Part B Supplier - Clinic/Group Practice 4486559549 Receives reassigned benefits from 272 practitioners
5 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Albany, GA; Americus, GA; Atlanta, GA; Camilla, GA; Cordele, GA; Fitzgerald, GA; Leesburg, GA; Moultrie, GA…

Other NPIs on the same Medicare enrollment 6

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 122

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 122

NPI Registry JSON

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

{
    "created_epoch": "1237766400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1392076800000",
    "number": "1821239765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3109",
            "city": "ALBANY",
            "state": "GA",
            "postal_code": "317063109",
            "telephone_number": "229-294-9233",
            "fax_number": "229-924-8146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 CURRY ST NE",
            "city": "PELHAM",
            "state": "GA",
            "postal_code": "317791457",
            "telephone_number": "229-294-9233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHOEBE PUTNEY MEMORIAL HOSPITAL, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-03-23",
        "last_updated": "2014-02-11",
        "status": "A",
        "authorized_official_last_name": "LAGESSE",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "SR VP PHYSICIAN SERVICES",
        "authorized_official_telephone_number": "229-312-1000"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "GA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Phoebe Family Medical Center - Pelham",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Pelham, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2014; 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.