NPIMap

Organization Active NPI

Georgia Neurosurgical Institute, P.C.

  • Neurological Surgery Physician
  • Macon, GA
National Provider Identifier
1972558336
Registry record updated Feb 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
Legal business name
GEORGIA NEUROSURGICAL INSTITUTE, P.C.
Practice address
840 Pine St
Suite 880
Macon, GA 31201-2100
Phone
(478) 743-7092
Fax
(478) 743-6293
NPI assigned
May 24, 2006
Last updated
Feb 9, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2024

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

Authorized official

Name
Mrs. Terri Wynn
Title
Practice Manager
Phone
(478) 743-7092

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X NU Primary

Addresses

Primary practice location

840 Pine St
Suite 880
Macon, GA 31201-2100

Mailing address

840 Pine St
Suite 880
Macon, GA 31201-2100
Phone (478) 743-7092

Other practice location 1

754 Plum St
Macon, GA 31201-7505
Phone (478) 743-7092

Other identifiers 1

IdentifierTypeStateIssuer
509880020AMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040521000071 GA Part B Supplier - Clinic/Group Practice 7517958234 Receives reassigned benefits from 27 practitioners
Practice locations: Macon, GA
O20100930005181 GA DME Supplier - Physician - Neurosurgery 7517958234 Practice locations: Macon, GA

National Provider Directory

National Provider Directory

Locations

777 Hemlock St
#98
Macon, GA 31201

115 Margie Dr
Warner Robins, GA 31093
Phone (478) 953-1377

115 Margie Dr
Ste F
Warner Robins, GA 31093

235 Margie Dr
Ste 100
Warner Robins, GA 31088
Phone (478) 417-8593

321 Margie Dr
#A
Warner Robins, GA 31088
Phone (478) 200-8152

328 Margie Dr
Ste A
Warner Robins, GA 31088
Phone (478) 971-7701

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": "1148428800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1707436800000",
    "number": "1972558336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "840 PINE ST",
            "address_2": "SUITE 880",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312012100",
            "telephone_number": "478-743-7092",
            "fax_number": "478-743-6293"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "840 PINE ST",
            "address_2": "SUITE 880",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312012100",
            "telephone_number": "478-743-7092",
            "fax_number": "478-743-6293"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "754 Plum St",
            "address_purpose": "LOCATION",
            "city": "Macon",
            "state": "GA",
            "postal_code": "312017505",
            "country_code": "US",
            "telephone_number": "478-743-7092",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "GEORGIA NEUROSURGICAL INSTITUTE, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-24",
        "last_updated": "2024-02-09",
        "certification_date": "2024-02-09",
        "status": "A",
        "authorized_official_last_name": "WYNN",
        "authorized_official_first_name": "TERRI",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "478-743-7092",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "509880020A",
            "state": "GA"
        }
    ],
    "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 Feb 9, 2024; 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.