NPIMap

Organization Active NPI

Medical Associates of Albany, P.C.

  • Internal Medicine Physician
  • Leesburg, GA
National Provider Identifier
1952396665
Registry record updated Feb 20, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
MEDICAL ASSOCIATES OF ALBANY, P.C.
Practice address
101 Oakland Crossing Dr
Leesburg, GA 31763-7228
Phone
(229) 432-1440
Fax
(229) 889-8263
NPI assigned
Sep 19, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2019

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

Authorized official

Name
Sandra C Ashberry
Title
Medicare Ar
Phone
(229) 889-9367

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

101 Oakland Crossing Dr
Leesburg, GA 31763-7228

Mailing address

PO Box 505
Albany, GA 31702-0505
Phone (229) 889-9367

Other identifiers 4

IdentifierTypeStateIssuer
085002011GMedicaidGA
300032673AMedicaidGA
CD3696OtherGARAILROAD MEDICARE GROUP #
300032673BMedicaidGA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040503000389 GA Part B Supplier - Clinic/Group Practice 7719975564 Receives reassigned benefits from 8 practitioners
Practice locations: Albany, GA; Leesburg, GA

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
11D0265755Medical Associates of Albany PC101 Oakland Crossing Dr, Leesburg, GA 31763ComplianceMar 1, 2028

National Provider Directory

National Provider Directory
Tax ID family
Medical Associates of Albany2 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.

Locations

101 Oakland Crossing Dr
Leesburg, GA 31763
Phone (229) 432-1440

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": "1127088000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1550620800000",
    "number": "1952396665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 505",
            "city": "ALBANY",
            "state": "GA",
            "postal_code": "317020505",
            "telephone_number": "229-889-9367",
            "fax_number": "229-317-0678"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 OAKLAND CROSSING DR",
            "city": "LEESBURG",
            "state": "GA",
            "postal_code": "317637228",
            "telephone_number": "229-432-1440",
            "fax_number": "229-889-8263"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL ASSOCIATES OF ALBANY, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-19",
        "last_updated": "2019-02-20",
        "status": "A",
        "authorized_official_last_name": "ASHBERRY",
        "authorized_official_first_name": "SANDRA",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "MEDICARE AR",
        "authorized_official_telephone_number": "229-889-9367"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "085002011G",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300032673A",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE GROUP #",
            "identifier": "CD3696",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300032673B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Leesburg, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.