PHOEBE PUTNEY MEMORIAL HOSPITAL (NPI# 1003937723) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003937723 |
| Entity Type | Organization |
| Organization Name | PHOEBE PUTNEY MEMORIAL HOSPITAL |
| Other Organization Name | PHOEBE FAMILY MEDICINE- LEESBURG |
| Practice Address |
1390 Us Highway 19 S Leesburg GA 31763-4831 |
| Mailing Address |
Po Box 2548 Albany GA 31702-2548 |
| Practice Telephone | 2298897490 |
| Practice Fax Number | 2298897495 |
| Mailing Telephone | 2293125870 |
| Mailing Fax Number | 2293125853 |
| Enumeration Date | 2007-04-02 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | FRANK F MIDDLETON III (DIRECTOR OF PHYSICIAN SERVICES) |
| Authorized Official Telephone | 2293124055 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| PHOEBE FAMILY MEDICINE- LEESBURG | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316060585 | Phoebe Putney Memorial Hospital | Family Medicine | 2410 Sylvester Rd, Albany, GA 31705-2479 | 2007-04-10 |
| 1225151491 | Phoebe Putney Memorial Hospital | Internal Medicine | 425 W 3rd Ave Ste 340, Albany, GA 31701-1968 | 2007-04-10 |
| 1134242308 | Phoebe Putney Memorial Hospital | Surgery | 425 W 3rd Ave Ste 510, Albany, GA 31701-1959 | 2007-04-10 |
| 1407979677 | Phoebe Putney Memorial Hospital | Family Medicine | 2336 Dawson Rd Ste 1600, Albany, GA 31707-2442 | 2007-04-10 |
| 1972625481 | Phoebe Putney Memorial Hospital | Surgery | 409 W 4th Ave, Albany, GA 31701-1915 | 2007-04-04 |
| 1669594222 | Phoebe Putney Memorial Hospital | Family Medicine | 2336 Dawson Rd Ste 1500, Albany, GA 31707-2442 | 2007-04-04 |
| 1225072846 | Phoebe Putney Memorial Hospital | Internal Medicine | 507 W 3rd Ave, Ste 100, Albany, GA 31701-1958 | 2006-06-15 |
| 1891315420 | Phoebe Putney Memorial Hospital | Pharmacy | 427 W 3rd Ave, Albany, GA 31701-1975 | 2020-04-23 |
| 1609268176 | Phoebe Putney Memorial Hospital | Family Medicine | 2336 Dawson Rd, Suite 2200, Albany, GA 31707-2800 | 2015-02-20 |
| 1487089132 | Phoebe Putney Memorial Hospital | General Acute Care Hospital | 417 W 3rd Ave, Albany, GA 31701-1943 | 2013-09-12 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | PHOEBE PUTNEY MEMORIAL HOSPITAL, INC. | 417 W 3rd Ave, Albany, GA 31706-1943 |
| Street Address |
1390 US HIGHWAY 19 S |
| City | LEESBURG |
| State | GA |
| Zip Code | 31763-4831 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609876200 | Homer Leon Lassiter Sr. | Family Medicine | 1390 Us Highway 19 S, Leesburg, GA 31763-4831 | 2005-07-26 |
| 1811537574 | Anthony Lance Gregory | Nurse Practitioner | 1390 Us Highway 19 S, Leesburg, GA 31763-4831 | 2020-01-10 |
| 1700262193 | Jason B Boyd | Nurse Practitioner | 1390 Us Highway 19 S, Leesburg, GA 31763-4831 | 2015-08-07 |
| 1760772313 | Shanda Dejoi Newsome | Family Medicine | 1390 Us Highway 19 S, Leesburg, GA 31763-4831 | 2011-04-17 |
| 1306932983 | Samrajya L.k. Gogineni | Internal Medicine | 1390 Us Highway 19 S, Leesburg, GA 31763-4831 | 2006-10-04 |
| 1033164843 | Barry L Barker | Family Medicine | 1390 Us Highway 19 S, Leesburg, GA 31763-4831 | 2006-05-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790150423 | Jamie Perrella Flynn-pressley | Counselor | 112 Cris Ann St., Leesburg, GA 31763 | 2015-12-07 |
| 1023429511 | Brookstone Medical LLC | Durable Medical Equipment & Medical Supplies | 123 Hugh Rd, Leesburg, GA 31763 | 2014-05-19 |
| 1124370796 | Freds Stores of Tennessee Inc | Pharmacy | 118 Robert B Lee Drive, Leesburg, GA 31763 | 2012-10-08 |
| 1255649273 | Lee County Optical LLC | Optometrist | 1569 Highway 19 South, Leesburg, GA 31763 | 2010-09-24 |
| 1851572473 | Shaun Nicholas Price | Chiropractor | 152 Robert B Lee Dr, # 31, Leesburg, GA 31763 | 2007-11-26 |
| 1710042007 | Williams & Bush Partnership | Dentist | 919 Us Hwy 19 South, Leesburg, GA 31763 | 2006-12-27 |
| 1063570398 | Lee County Board of Education | Local Education Agency (LEA) | 126 Starksville Avenue, North, Leesburg, GA 31763 | 2006-12-06 |
| 1225109929 | Lee County School System | Local Education Agency (LEA) | 126 Starksville Avenue North, Leesburg, GA 31763 | 2006-11-13 |
| 1073682936 | Adams' Loving Pro Home Health Care Inc. | Home Health | 1277 Hwy 82 West, 121, Leesburg, GA 31763 | 2006-11-07 |
| 1225132699 | Deirdre Mae Clairewen Lawson | Internal Medicine | 235 Walnut Street, Leesburg, GA 31763 | 2006-09-07 |
| Find all providers in zip 31763 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306443684 | Montage Health and Wellness Corp | Family Medicine | 305 E Market St Ste O, Leesburg, VA 20176-4169 | 2020-10-08 |
| 1902325608 | Loudoun Medical Group, P.C. | Family Medicine | 224d Cornwall St Nw Ste 102, Leesburg, VA 20176-2700 | 2017-09-13 |
| 1912352741 | Jessica Omodele Wright | Family Medicine | 51 Catocin Cir Ne, Leesburg, VA 20176-3100 | 2016-04-29 |
| 1528491156 | Carehere LLC | Family Medicine | 1908 Center St, Leesburg, FL 34748-4812 | 2013-08-19 |
| 1992049654 | Jan Julius Brandt | Family Medicine | 14682 Chapel Ln, Leesburg, VA 20176-5276 | 2012-11-19 |
| 1447523493 | Pablo Doldy Cardona | Family Medicine | 26540 Ace Ave Ste 108c, Leesburg, FL 34748-8279 | 2012-02-21 |
| 1245518638 | Yashel Wedderburn Landell | Family Medicine | 8113 Centralia Ct Ste 102, Leesburg, FL 34788-7521 | 2011-08-02 |
| 1851608053 | Rolando J Menendez Md Pa | Family Medicine | 733 N 3rd St, Leesburg, FL 34748-4441 | 2010-09-09 |
| 1922291848 | William Joseph Briglia Sr. | Family Medicine | 4293 Rt 47, Medical Dept Bayside State Prison, Leesburg, NJ 08327 | 2007-08-23 |
| 1376636134 | Yoyen Lau | Family Medicine | 280 Industrial Blvd, Leesburg, AL 35983 | 2006-10-02 |
| Find all providers in LEESBURG | ||||
Please comment or provide details below to improve the information on PHOEBE PUTNEY MEMORIAL HOSPITAL.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.