Family Practice Assoicates LLC

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

28796 Issued in GA

Legal business name

FAMILY PRACTICE ASSOICATES LLC

Practice address

612 Love Ave
Tifton, GA 31794

Phone

(229) 391-3300

Fax

(229) 388-1948

NPI assigned

May 3, 2007

Last updated

May 8, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Carl David Johnson III, MDNPI 1023018561

Title

Practice Owner/Physician

Phone

(229) 391-3300

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

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.

• Carl David Johnson III, MD

  • Family Medicine Physician
  • Tifton, GA
  • NPI 1023018561
  Authorized official Same address or phone

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

{
    "created_epoch": "1178150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1431043200000",
    "number": "1972725216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "612 LOVE AVE",
            "city": "TIFTON",
            "state": "GA",
            "postal_code": "31794",
            "telephone_number": "229-391-3300",
            "fax_number": "229-388-1948"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "612 LOVE AVE",
            "city": "TIFTON",
            "state": "GA",
            "postal_code": "31794",
            "telephone_number": "229-391-3300",
            "fax_number": "229-388-1948"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY PRACTICE ASSOICATES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-03",
        "last_updated": "2015-05-08",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "CARL",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "PRACTICE OWNER/PHYSICIAN",
        "authorized_official_telephone_number": "229-391-3300",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "GA",
            "license": "28796",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "85002772G",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alberto Espinola, MD
• Raymond C Evans, MD
• John Ewing, RPH
• Family Health Center of Tiftarea
• Family Practice Associates of Tiftarea
• Family Primecare, LLC
• Heath Farmer, CRNA
• Carolyn Jean Felton, M.D.
• Nora Anne Fine, MD
• Alison Lindsey Fitzgerald, MSN, CNM

• General Practice Physician in Tifton, GA
• Providers in Tifton, GA by specialty
• General Practice Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.