Lighthouse Family Practice

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

042704 Issued in GA

Legal business name

LIGHTHOUSE FAMILY PRACTICE

Practice address

12134 Augusta Rd
Ste a
Lavonia, GA 30553-1208

Phone

(706) 377-3349

NPI assigned

Nov 21, 2006

Organization subpart

No

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

Authorized official

Name

Paul E Raber, DO

Title

Owner Physician

Phone

(706) 377-3349

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1164067200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1465862400000",
    "number": "1881769461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12134 AUGUSTA RD",
            "city": "LAVONIA",
            "state": "GA",
            "postal_code": "305531208",
            "telephone_number": "706-356-1422",
            "fax_number": "706-356-1425"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12134 AUGUSTA RD",
            "address_2": "STE A",
            "city": "LAVONIA",
            "state": "GA",
            "postal_code": "305531208",
            "telephone_number": "706-377-3349"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIGHTHOUSE FAMILY PRACTICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-21",
        "last_updated": "2016-06-14",
        "status": "A",
        "authorized_official_last_name": "RABER",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER PHYSICIAN",
        "authorized_official_telephone_number": "706-377-3349",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "042704",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Victoria Lynn Jordan, FNP-C
• James A Joseph, CRNA
• Gordon M Kelly, MD
• Lavonia Emergency Group LLC
• Lavonia Physician Services, LLC
• David C Martin, M.D.
• Jenson T Mathew, MD
• Medics of Northeast Georgia, Incorporated
• Albert B. Mercer, M.D.
• Dawn C Morgan, CPNP

• Family Medicine Physician in Lavonia, GA
• Providers in Lavonia, GA by specialty
• Family Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2016; 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.