NPIMap

Organization Active NPI

Midtown Infusion Center

  • Infusion Therapy Clinic/Center
  • Macon, GA
National Provider Identifier
1922558352
Registry record updated Oct 10, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infusion Therapy Clinic/CenterTaxonomy code 261QI0500X
Legal business name
MIDTOWN INFUSION CENTER
Practice address
1445 Georgia Ave Ste 2
Macon, GA 31201-7610
Phone
(478) 250-1325
Fax
(478) 254-6860
NPI assigned
Oct 10, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2016

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

Authorized official

Name
Dr. Reuben K Ellis, MDNPI 1114969110
Title
Ceo
Phone
(478) 250-1325

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Infusion Therapy Clinic/Center 261QI0500X Primary

Addresses

Primary practice location

1445 Georgia Ave Ste 2
Macon, GA 31201-7610

Mailing address

1445 Georgia Ave Ste 2
Macon, GA 31201-7610
Phone (478) 250-1325

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20161129000492 GA Part B Supplier - Clinic/Group Practice 3870873375 Receives reassigned benefits from 4 practitioners
Practice locations: Macon, GA

National Provider Directory

National Provider Directory

Locations

1425 Georgia Ave
Ste 201B
Macon, GA 31201
Phone (478) 250-1325

Practitioners & affiliated clinicians

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1476057600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1476057600000",
    "number": "1922558352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1445 GEORGIA AVE STE 2",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312017610",
            "telephone_number": "478-250-1325",
            "fax_number": "478-254-6860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1445 GEORGIA AVE STE 2",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312017610",
            "telephone_number": "478-250-1325",
            "fax_number": "478-254-6860"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDTOWN INFUSION CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-10",
        "last_updated": "2016-10-10",
        "status": "A",
        "authorized_official_last_name": "ELLIS",
        "authorized_official_first_name": "REUBEN",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "478-250-1325",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QI0500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Infusion Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Macon, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.