Active NPI
Endoscopy ASC of Middle Georgia LLC
- Ambulatory Surgical Clinic/Center
- Macon, GA
National Provider Identifier
1992423719
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ambulatory Surgical Clinic/Center
- Legal business name
- ENDOSCOPY ASC OF MIDDLE GEORGIA LLC
- Practice address
- 610 3Rd St Ste 102
Macon, GA 31201-3293 - Phone
- (478) 464-2600
- NPI assigned
- Aug 17, 2022
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Collin Lemaistre
- Title
- Officer/Authorized Official
- Phone
- (469) 250-3640
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ambulatory Surgical Clinic/Center | 261QA1903X | Primary |
Addresses
Primary practice location
610 3Rd St Ste 102
Macon, GA 31201-3293
Mailing address
610 3Rd St Ste 102
Macon, GA 31201-3293
Phone (478) 464-2600
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | https://esmd.abilitynetwork.com:8291/gateway/documentsubmission/2_0/NhinService/XDRRequest_Service | Other | Ability Network |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20221212001307 | GA | Part B Supplier - Ambulatory Surgical Center | 8729457874 | Practice locations: Macon, GA |
National Provider Directory
National Provider DirectoryMember of 2
Organizations this organization is a member of, according to the National Provider Directory.
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Gastroenterology Physician
- Macon, GA
- NPI 1689659260
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1660694400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1728259200000",
"number": "1992423719",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "610 3RD ST STE 102",
"city": "MACON",
"state": "GA",
"postal_code": "312013293",
"telephone_number": "478-464-2600"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "610 3RD ST STE 102",
"city": "MACON",
"state": "GA",
"postal_code": "312013293",
"telephone_number": "478-464-2600"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ENDOSCOPY ASC OF MIDDLE GEORGIA LLC",
"organizational_subpart": "NO",
"enumeration_date": "2022-08-17",
"last_updated": "2024-10-07",
"certification_date": "2024-10-07",
"status": "A",
"authorized_official_last_name": "LEMAISTRE",
"authorized_official_first_name": "COLLIN",
"authorized_official_title_or_position": "OFFICER/AUTHORIZED OFFICIAL",
"authorized_official_telephone_number": "469-250-3640"
},
"taxonomies": [
{
"code": "261QA1903X",
"taxonomy_group": "",
"desc": "Clinic/Center, Ambulatory Surgical",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "https://esmd.abilitynetwork.com:8291/gateway/documentsubmission/2_0/NhinService/XDRRequest_Service",
"affiliation": "Y",
"endpointDescription": "2.16.840.1.113883.3.667.2",
"affiliationName": "Ability Network",
"use": "OTHER",
"useDescription": "Other",
"useOtherDescription": "CMS esMD eMDR",
"address_1": "100 N 6th St Ste 900A",
"city": "Minneapolis",
"state": "MN",
"country_code": "US",
"postal_code": "554031516",
"country_name": "United States",
"address_type": "DOM"
}
],
"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 Oct 7, 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.