Robert Land, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

11017 Issued in GA

Practice address

417 Broad St S
Abbeville, GA 31001-4305

Phone

(229) 467-3209

Fax

(229) 467-3212

NPI assigned

Nov 15, 2019

Last updated

Jun 20, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

DMC Physician Group LLCGroup PAC ID 8628296845, 20 clinicians

Crisp Regional Hospital IncGroup PAC ID 5991616336, 65 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Crisp Regional Hospital Hospital, Cordele, GA, CCN 110104
• Dorminy Medical Center Hospital, Fitzgerald, GA, CCN 110073

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Crisp Regional Hospital Inc

  dba Crisp Regional Hospital

  • General Acute Care Hospital
  • Cordele, GA
  • NPI 1700851649
  Medicare reassignment Care Compare group NPD
• DMC Physician Group LLC

  • Multi-Specialty Clinic/Center
  • Fitzgerald, GA
  • NPI 1124430020
  Medicare reassignment Care Compare group NPD
• Crisp Regional Hospital, Inc

  dba Crisp Regional LTC Pharmacy

  • Long Term Care Pharmacy
  • Cordele, GA
  • NPI 1679836142
  NPD
• DMC Physician Group LLC

  dba DMC Primary Care

  • Rural Health Clinic/Center
  • Fitzgerald, GA
  • NPI 1922672120
  NPD
• Aiken Emergency Physicians

  • Primary Care Nurse Practitioner
  • Aiken, SC
  • NPI 1205622362
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Crisp Regional Hospital Inc

  dba Crisp Regional Hospital

  • General Acute Care Hospital
  • Cordele, GA
  • NPI 1700851649
  Care Compare affiliation

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

{
    "created_epoch": "1573776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655683200000",
    "number": "1972148708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "417 BROAD ST S",
            "city": "ABBEVILLE",
            "state": "GA",
            "postal_code": "310014305",
            "telephone_number": "229-467-3209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "417 BROAD ST S",
            "city": "ABBEVILLE",
            "state": "GA",
            "postal_code": "310014305",
            "telephone_number": "229-467-3209",
            "fax_number": "229-467-3212"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "216 Edgefield Ave NW",
            "address_purpose": "LOCATION",
            "city": "Aiken",
            "state": "SC",
            "postal_code": "298013910",
            "country_code": "US",
            "telephone_number": "803-648-4224",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "613 S Grant St",
            "address_purpose": "LOCATION",
            "city": "Fitzgerald",
            "state": "GA",
            "postal_code": "317503315",
            "country_code": "US",
            "telephone_number": "229-424-0134",
            "fax_number": "229-424-7390",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LAND",
        "first_name": "ROBERT",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-11-15",
        "last_updated": "2022-06-20",
        "certification_date": "2022-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "11017",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SC",
            "license": "3418",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• DMC Physician Group LLC (Abbeville Primary Care)
• Global Abbeville, LLC (Glen Eagle Healthcare and Rehab)
• Ashley Handley, APRN, FNP-C
• High Cotton Homes, LLC
• Lisa S Hunter, LCSW
• Abigail Dewitt Leone, LPC
• Brenda Faye Madison
• Kristian McRae
• MM Adult Care, Inc.
• Toni Munford, LPN

• Physician Assistant in Abbeville, GA
• Providers in Abbeville, GA by specialty
• Physician Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.