George Lycurglus Petty, M.D.

Primary specialty

Adult Medicine PhysicianTaxonomy code 207QA0505X

License

MD.34536 Issued in AL

Practice address

1314 19TH Ave
Meridian, MS 39301

Phone

(205) 270-9467

NPI assigned

May 24, 2013

Last updated

Aug 24, 2018By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in AL

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

Specialty

Family PracticeAlso: Emergency Medicine

Education

University of South Alabama College of Medicine, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Southeast Physician Network, P.C.Group PAC ID 0840337721, 46 clinicians

Relias Emergency Medicine Specialists of Northport, LLCGroup PAC ID 2668724634, 22 clinicians

Sycamore Lakeland LLCGroup PAC ID 2668915471, 22 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• DCH Regional Medical Center Hospital, Tuscaloosa, AL, CCN 010092

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Southeast Physician Network, P.C.

  • Hematology & Oncology Physician
  • Tuscaloosa, AL
  • NPI 1598090839
  Medicare reassignment Care Compare group NPD
• Sycamore Lakeland LLC

  • Emergency Medicine Physician
  • Haleyville, AL
  • NPI 1184472789
  Medicare reassignment Care Compare group NPD
• Relias Emergency Medicine Specialists of Northport, LLC

  • Emergency Medicine Physician
  • Northport, AL
  • NPI 1699261149
  Medicare reassignment Care Compare group
• Relias Emergency Medicine Specialists of Regional, LLC

  • Emergency Medicine Physician
  • Tuscaloosa, AL
  • NPI 1619463163
  Medicare reassignment NPD
• Sycamore Physicians LLC

  • Emergency Medicine Physician
  • Opp, AL
  • NPI 1780372557
  Medicare reassignment NPD
• Southeast Physician Network, P.C.

  • Hematology & Oncology Physician
  • Tuscaloosa, AL
  • NPI 1255813119
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• The DCH Health Care Authority

  dba DCH Health & Wellness Clinic

  • Clinic/Center
  • Tuscaloosa, AL
  • NPI 1306613211

  Hospital

  Care Compare affiliation
• The DCH Health Care Authority

  dba DCH Outpatient Services

  • Clinic/Center
  • Tuscaloosa, AL
  • NPI 1780927681

  Hospital

  Care Compare affiliation
• The DCH Healthcare Authority

  dba DCH Regional Medical Center

  • General Acute Care Hospital
  • Tuscaloosa, AL
  • NPI 1841394418
  Care Compare affiliation

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

{
    "created_epoch": "1369353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535068800000",
    "number": "1831536333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1901 5TH AVE E UNIT 1113",
            "city": "TUSCALOOSA",
            "state": "AL",
            "postal_code": "354013868",
            "telephone_number": "205-270-9467",
            "fax_number": "205-348-5294"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1314 19TH AVE",
            "city": "MERIDIAN",
            "state": "MS",
            "postal_code": "39301",
            "telephone_number": "205-270-9467"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "850 5th Ave E",
            "address_purpose": "LOCATION",
            "city": "Tuscaloosa",
            "state": "AL",
            "postal_code": "354017419",
            "country_code": "US",
            "telephone_number": "205-348-1770",
            "fax_number": "205-348-5294",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PETTY",
        "first_name": "GEORGE",
        "middle_name": "LYCURGLUS",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-05-24",
        "last_updated": "2018-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MS",
            "license": "24118",
            "primary": false
        },
        {
            "code": "207QA0505X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adult Medicine",
            "state": "AL",
            "license": "MD.34536",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James Dean Perkins, M.D.
• Laura Elizabeth Perry, FNP
• Brett J. Person, M.D.
• Kristin Taylor Peterson, FNP-C
• Neva Jo Pettigrew, FNP
• Hai Tan Pham, MD
• Minh Pham, MD
• Phi Health, LLC (PHI Air Medical)
• Francis M. Phillippi III, M.D.
• Phillips Eye Care, Inc. (Bright Eyes Family Eye Care)

• Adult Medicine Physician in Meridian, MS
• Providers in Meridian, MS by specialty
• Adult Medicine Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2018; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.