NPIMap

Organization Active NPI

Randy Lentz MD

  • Clinic/Center
  • Jesup, GA
National Provider Identifier
1881097483
Registry record updated Sep 27, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
050500 Issued in GA
Legal business name
RANDY LENTZ MD
Practice address
182 Sunset Blvd
Jesup, GA 31545-0401
Phone
(912) 385-2102
NPI assigned
Sep 27, 2014
Last updated
Sep 27, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2014

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

Authorized official

Name
Dr. Randy Scott Lentz, MDNPI 1205832227
Title
Physician
Phone
(912) 385-2102

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X 050500 GA Primary

Addresses

Primary practice location

182 Sunset Blvd
Jesup, GA 31545-0401

Mailing address

182 Sunset Blvd
Jesup, GA 31545-0401
Phone (912) 385-2102

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
11D0990931Randy S Lentz, MD182 Sunset Boulevard, Jesup, GA 31545Certificate of waiverSep 5, 2027

National Provider Directory

National Provider Directory
Tax ID family
Lentz Urgent Care Family Med Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

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": "1411776000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1411776000000",
    "number": "1881097483",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "182 SUNSET BLVD",
            "city": "JESUP",
            "state": "GA",
            "postal_code": "315450401",
            "telephone_number": "912-385-2102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "182 SUNSET BLVD",
            "city": "JESUP",
            "state": "GA",
            "postal_code": "315450401",
            "telephone_number": "912-385-2102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RANDY LENTZ MD",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-27",
        "last_updated": "2014-09-27",
        "status": "A",
        "authorized_official_last_name": "LENTZ",
        "authorized_official_first_name": "RANDY",
        "authorized_official_middle_name": "SCOTT",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "912-385-2102",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "GA",
            "license": "050500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jesup, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.