Augusta Primary Care Services LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

AUGUSTA PRIMARY CARE SERVICES LLC

Practice address

3624 J Dewey Gray Cir
Suite 308
Augusta, GA 30909-6584

Phone

(706) 855-5650

Fax

(706) 863-0821

NPI assigned

Jul 16, 2008

Last updated

Oct 17, 2017By the provider in NPPES

Organization subpart

Yes

Parent organization

HOSPITAL CORP., LLCAs reported in NPPES

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

Authorized official

Name

Robert Faile

Title

Vice President

Phone

(843) 856-7923

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Locations

Practitioners 66

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.

• James Christopher Bardoner, M.D.

  • Surgery Physician
  • Augusta, GA
  • NPI 1558652032
  Medicare reassignment Care Compare group NPD
• Kendra Batey, MD

  • Surgical Critical Care Physician
  • Augusta, GA
  • NPI 1811488505
  Medicare reassignment Care Compare group NPD
• Robert Steven Blackwelder

  • Acute Care Nurse Practitioner
  • Augusta, GA
  • NPI 1558993576
  Medicare reassignment Care Compare group NPD
• Michael W Blaney, MD

  • Surgery Physician
  • Martinez, GA
  • NPI 1992881122
  Medicare reassignment Care Compare group NPD
• Chris Charles Carlson, M.D.

  • Surgery Physician
  • Augusta, GA
  • NPI 1629062443
  Medicare reassignment Care Compare group NPD
• Phyllis Pelfrey Costello, MSN

  • Nurse Practitioner
  • Augusta, GA
  • NPI 1487081261
  Medicare reassignment Care Compare group NPD
• Jody Christopher Criswell, NP

  • Nurse Practitioner
  • Augusta, GA
  • NPI 1346893161
  Medicare reassignment Care Compare group NPD
• Sudarshana Datta

  • Interventional Cardiology Physician
  • Augusta, GA
  • NPI 1275096190

  Internal Medicine

  Medicare reassignment Care Compare group NPD
• Dominic Rudolph Gallo, M.D.

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Augusta, GA
  • NPI 1891803821
  Medicare reassignment Care Compare group NPD
• Douglas Truman Garrett Jr., NP

  • Nurse Practitioner
  • Appling, GA
  • NPI 1912511064
  Medicare reassignment Care Compare group NPD
• Robert Adam Hardy, DNP

  • Family Nurse Practitioner
  • Augusta, GA
  • NPI 1770191470
  Medicare reassignment Care Compare group NPD
• Christopher S Hogan, MD

  • Surgery Physician
  • Augusta, GA
  • NPI 1932220233
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1216166400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1508198400000",
    "number": "1952565210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3624 J DEWEY GRAY CIR",
            "address_2": "SUITE 308",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309096584",
            "telephone_number": "706-855-5650",
            "fax_number": "706-863-0821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3624 J DEWEY GRAY CIR",
            "address_2": "SUITE 308",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309096584",
            "telephone_number": "706-855-5650",
            "fax_number": "706-863-0821"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AUGUSTA PRIMARY CARE SERVICES LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "HOSPITAL CORP., LLC",
        "enumeration_date": "2008-07-16",
        "last_updated": "2017-10-17",
        "status": "A",
        "authorized_official_last_name": "FAILE",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "843-856-7923"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "298706473A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "298706473B",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP5358",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Augusta Physician Services LLC
• Augusta Physicians Group, LLC
• Augusta Podiatry Associates
• Augusta Preventive Cardiology
• Augusta Preventive Cardiology
• Augusta Primary Care Services, LLC (Augusta Health Spec-Urology)
• Augusta Primary Care Services, LLC
• Augusta Prosthetics & Orthotics Inc (Augusta Orthotics & Prosthetics, Inc.)
• Augusta Psychiatry and Therapy Associates, LLC
• Augusta Rehabilitation Associates, P.C.

• Internal Medicine Physician in Augusta, GA
• Providers in Augusta, GA by specialty
• Internal Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2017; 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.