Organization Active NPI

Wrightsboro Emergency Group LLC

  • Emergency Medicine Physician
  • Augusta, GA
National Provider Identifier
1861871980
Registry record updated Jul 11, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
Legal business name
WRIGHTSBORO EMERGENCY GROUP LLC
Practice address
2260 Wrightsboro Rd
Augusta, GA 30904-4764
Phone
(800) 893-9698
NPI assigned
May 21, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2017

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

Authorized official

Name
Lisha C Falk
Title
VP of Contracting
Phone
(800) 893-9698

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207P00000X GA Primary
Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363A00000X GA
Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363L00000X GA

Addresses

Primary practice location

2260 Wrightsboro Rd
Augusta, GA 30904-4764

Mailing address

200 Corporate Blvd
Lafayette, LA 70508-3870
Phone (800) 893-9698

Other identifiers 1

IdentifierTypeStateIssuer
003161266AMedicaidGA

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1432166400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1499731200000",
    "number": "1861871980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 CORPORATE BLVD",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705083870",
            "telephone_number": "800-893-9698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2260 WRIGHTSBORO RD",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309044764",
            "telephone_number": "800-893-9698"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WRIGHTSBORO EMERGENCY GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-21",
        "last_updated": "2017-07-11",
        "status": "A",
        "authorized_official_last_name": "FALK",
        "authorized_official_first_name": "LISHA",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "VP OF CONTRACTING",
        "authorized_official_telephone_number": "800-893-9698"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Emergency Medicine",
            "state": "GA",
            "license": null,
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003161266A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Augusta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2017; 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.