NPIMap

Organization Active NPI

Doctors of Compassionate Services

  • Family Medicine Physician
  • Baxley, GA
National Provider Identifier
1821378076
Registry record updated Aug 19, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
049292 Issued in GA
Legal business name
DOCTORS OF COMPASSIONATE SERVICES
Practice address
277 Lackawanna St
Baxley, GA 31513
Phone
(912) 366-1362
Fax
(912) 366-1365
NPI assigned
Aug 19, 2011
Last updated
Aug 19, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2011

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

Authorized official

Name
Mr. Patrick Julian Fordham
Title
VP
Phone
(912) 366-1362

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X 049292 GA Primary

Addresses

Primary practice location

277 Lackawanna St
Baxley, GA 31513

Mailing address

277 Lackawanna St
Baxley, GA 31513-8072
Phone (912) 366-1362

National Provider Directory

National Provider Directory

Locations

18 Luckie St
Baxley, GA 31513

18 Luckie St
Ste F
Baxley, GA 31513
Phone (912) 366-1362

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/11298/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 4

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": "1313712000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1313712000000",
    "number": "1821378076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "277 LACKAWANNA ST",
            "city": "BAXLEY",
            "state": "GA",
            "postal_code": "315138072",
            "telephone_number": "912-366-1362",
            "fax_number": "912-366-1365"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "277 LACKAWANNA ST",
            "city": "BAXLEY",
            "state": "GA",
            "postal_code": "31513",
            "telephone_number": "912-366-1362",
            "fax_number": "912-366-1365"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DOCTORS OF COMPASSIONATE SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-19",
        "last_updated": "2011-08-19",
        "status": "A",
        "authorized_official_last_name": "FORDHAM",
        "authorized_official_first_name": "PATRICK",
        "authorized_official_middle_name": "JULIAN",
        "authorized_official_title_or_position": "VP",
        "authorized_official_telephone_number": "912-366-1362",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "049292",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baxley, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.