Individual provider Active NPI

William Michael Cantrell, MD

  • Family Medicine Physician
  • Augusta, GA
National Provider Identifier
1982195038
Registry record updated May 24, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
009932 Issued in GA
Practice address
1120 15TH St.
Augusta, GA 30912
Phone
(706) 721-2273
NPI assigned
May 24, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 24, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 009932 GA Primary

Addresses

Primary practice location

1120 15TH St.
Augusta, GA 30912

Mailing address

1120 15TH St
Augusta, GA 30912-0004

Medicare participation

Medicare enrollment files
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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210421001548 GA Practitioner - Family Practice 2163771361 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Statesboro Hma Physician Management LLCGroup PAC ID 8820196058, 23 clinicians

Practice addresses (Care Compare)

1499 Fair Rd
Statesboro, GA 30458-1683
Phone (912) 871-5437

Hospital & facility affiliations

  • East Georgia Regional Medical Center Hospital, Statesboro, GA, CCN 110075
  • Candler County Hospital Hospital, Metter, GA, CCN 111334
  • Emanuel Medical Center Hospital, Swainsboro, GA, CCN 110109
  • Evans Memorial Hospital Hospital, Claxton, GA, CCN 110142

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
009932GAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Statesboro Hma Physician Management LLC CurrentSince Jun 1, 2021 Accepting new patients

Locations

1499 Fair Rd
Statesboro, GA 30458
Phone (912) 486-1000

Organizations & group practices 1

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

Hospital & facility affiliations 4

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

NPI Registry JSON

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

{
    "created_epoch": "1527120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1527120000000",
    "number": "1982195038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1120 15TH ST",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309120004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1120 15TH ST.",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "30912",
            "telephone_number": "706-721-2273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANTRELL",
        "first_name": "WILLIAM",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-05-24",
        "last_updated": "2018-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "009932",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Augusta, GA

Sources for this page

Verify at the official NPI Registry.