Brunswick Endoscopy Center, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

063-134 Issued in GA

Legal business name

BRUNSWICK ENDOSCOPY CENTER, LLC

Practice address

3217 4TH St
Brunswick, GA 31520-3759

Phone

(912) 267-1802

Fax

(912) 267-0061

NPI assigned

May 26, 2006

Last updated

May 14, 2008By 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

Rita Y Warren, R.N.

Title

Administrator

Phone

(912) 267-1802

Specialties & licenses 1

Addresses

Other identifiers 1

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.

• Huitt Everett Mattox III, M.D.

  • Gastroenterology Physician
  • Brunswick, GA
  • NPI 1548255920
  NPD (past)

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

{
    "created_epoch": "1148601600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210723200000",
    "number": "1922054410",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3217 4TH ST",
            "city": "BRUNSWICK",
            "state": "GA",
            "postal_code": "315203759",
            "telephone_number": "912-267-1802",
            "fax_number": "912-267-0061"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3217 4TH ST",
            "city": "BRUNSWICK",
            "state": "GA",
            "postal_code": "315203759",
            "telephone_number": "912-267-1802",
            "fax_number": "912-267-0061"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRUNSWICK ENDOSCOPY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-26",
        "last_updated": "2008-05-14",
        "status": "A",
        "authorized_official_last_name": "WARREN",
        "authorized_official_first_name": "RITA",
        "authorized_official_middle_name": "Y",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "912-267-1802",
        "authorized_official_credential": "R.N."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "GA",
            "license": "063-134",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00763639A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Summer Bruce, RBT
• Katelyn Bruno, RBT
• Mardell Z Brunson
• Brunswick Addiction Associates, LLC (Treatment Center of Brunswick)
• Brunswick Dentisty LLC (Brunswick Smiles)
• Brunswick Medical LLC
• Brunswick Medical Supply Inc
• Brunswick Orthotics & Prosthetics, Inc.
• Brunswick Pain Treatment Center, LLC
• Brunswick Urgent Care, LLC

• Ambulatory Surgical Clinic/Center in Brunswick, GA
• Providers in Brunswick, GA by specialty
• Ambulatory Surgical Clinic/Center in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2008; 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.