Port City Pulmonary Care, Inc.

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

20012275392 Issued in GA

Legal business name

PORT CITY PULMONARY CARE, INC.

Practice address

1500 E Shotwell St
Bainbridge, GA 39819-4256

Phone

(229) 246-3500

Fax

(229) 246-8142

NPI assigned

Dec 11, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Ed Newton

Title

Ceo

Phone

(229) 246-3500

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1165795200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1841350790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 E SHOTWELL ST",
            "city": "BAINBRIDGE",
            "state": "GA",
            "postal_code": "398194256",
            "telephone_number": "229-246-3500",
            "fax_number": "229-246-8142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 E SHOTWELL ST",
            "city": "BAINBRIDGE",
            "state": "GA",
            "postal_code": "398194256",
            "telephone_number": "229-246-3500",
            "fax_number": "229-246-8142"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PORT CITY PULMONARY CARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-11",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "NEWTON",
        "authorized_official_first_name": "ED",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "229-246-3500",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "GA",
            "license": "20012275392",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jerry David Phillips Jr., M.D.
• Kelly Phillips, SLP
• Port City Family Dental Associates
• Port City Family Medicine, L.L.C.
• Port City Medical Associates Inc (Bainbridge Treatment Center)
• Port City Urgent Care L.L.C.
• Port Medical Management Inc (The Bridge)
• Jennifer T. Powell
• Zacharey Alan Powell, DNP, FNP-C
• Laura Ashley Pratt, PTA

• Durable Medical Equipment & Medical Supplies in Bainbridge, GA
• Providers in Bainbridge, GA by specialty
• Durable Medical Equipment & Medical Supplies in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.