NPIMap

Organization Active NPI

The ENT Center of Central Georgia, P.C.

  • Otolaryngology Physician
  • Macon, GA
National Provider Identifier
1962449363
Registry record updated May 29, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
Legal business name
THE ENT CENTER OF CENTRAL GEORGIA, P.C.
Practice address
540 Hemlock St
Macon, GA 31201-3202
Phone
(478) 743-8953
Fax
(478) 743-1963
NPI assigned
Jun 2, 2006
Last updated
May 29, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 29, 2019

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

Authorized official

Name
Keith D. Holmes, MDNPI 1104882281
Title
President
Phone
(478) 743-8953

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
Otolaryngology Physician 207Y00000X Primary

Addresses

Primary practice location

540 Hemlock St
Macon, GA 31201-3202

Mailing address

540 Hemlock St
Macon, GA 31201-3202
Phone (478) 743-8953

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040524000395 GA Part B Supplier - Clinic/Group Practice 6103817556 Receives reassigned benefits from 26 practitioners
Practice locations: Warner Robins, GA; Macon, 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
11D2057718ENT Center of Central Georgia, the540 Hemlock Street, Macon, GA 31201Certificate of waiverApr 22, 2027

National Provider Directory

National Provider Directory
Tax ID family
Evans Memorial Hospital Inc6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

Locations

110 Regency Park Dr
Ste A
McDonough, GA 30253
Phone (770) 320-7023

6084 Lakeview Rd
Warner Robins, GA 31088
Phone (478) 743-8953

6084 Lakeview Rd
Ste 100
Warner Robins, GA 31088
Phone (478) 743-8953

Practitioners & affiliated clinicians

Practitioners 30

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.

View all 30

NPI Registry JSON

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

{
    "created_epoch": "1149206400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1559088000000",
    "number": "1962449363",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "540 HEMLOCK ST",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312013202",
            "telephone_number": "478-743-8953",
            "fax_number": "478-743-1963"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "540 HEMLOCK ST",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312013202",
            "telephone_number": "478-743-8953",
            "fax_number": "478-743-1963"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE ENT CENTER OF CENTRAL GEORGIA, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-02",
        "last_updated": "2019-05-29",
        "status": "A",
        "authorized_official_last_name": "HOLMES",
        "authorized_official_first_name": "KEITH",
        "authorized_official_middle_name": "D.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "478-743-8953",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "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 May 29, 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.