THE CORPORATION OF MERCER UNIVERSITY (NPI# 1174693162) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174693162 |
| Entity Type | Organization |
| Organization Name | THE CORPORATION OF MERCER UNIVERSITY |
| Other Organization Name | MERCER HEALTH SYSTEMS |
| Practice Address |
250 Martin Luther King Jr Blvd Macon GA 31201-3490 |
| Practice Telephone | 4783014111 |
| Practice Fax Number | 4783012272 |
| Mailing Telephone | 4783012362 |
| Mailing Fax Number | 4783012272 |
| Enumeration Date | 2006-11-08 |
| Last Update Date | 2020-10-15 |
| Authorized Official Name | CHARLES DUFFEY (COO) |
| Authorized Official Telephone | 4783012362 |
| Is Organization Subpart | Y |
| Parent Organization Name | THE CORPORATION OF MERCER UNIVERSITY |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YM0800X |
Counselor Specialization: Mental Health |
Behavioral Health & Social Service Providers | ||
| N | 103TB0200X |
Psychologist Specialization: Cognitive & Behavioral |
Behavioral Health & Social Service Providers | ||
| N | 103TC2200X |
Psychologist Specialization: Clinical Child & Adolescent |
Behavioral Health & Social Service Providers | ||
| N | 104100000X | Social Worker | Behavioral Health & Social Service Providers | ||
| N | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians | ||
| N | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
Allopathic & Osteopathic Physicians | ||
| N | 207RE0101X |
Internal Medicine Specialization: Endocrinology, Diabetes & Metabolism |
Allopathic & Osteopathic Physicians | ||
| N | 207RI0200X |
Internal Medicine Specialization: Infectious Disease |
Allopathic & Osteopathic Physicians | ||
| N | 207RN0300X |
Internal Medicine Specialization: Nephrology |
Allopathic & Osteopathic Physicians | ||
| N | 207RP1001X |
Internal Medicine Specialization: Pulmonary Disease |
Allopathic & Osteopathic Physicians | ||
| N | 2084F0202X |
Psychiatry & Neurology Specialization: Forensic Psychiatry |
Allopathic & Osteopathic Physicians | ||
| N | 2084P0804X |
Psychiatry & Neurology Specialization: Child & Adolescent Psychiatry |
Allopathic & Osteopathic Physicians | ||
| N | 2084P0805X |
Psychiatry & Neurology Specialization: Geriatric Psychiatry |
Allopathic & Osteopathic Physicians | ||
| N | 2084P2900X |
Psychiatry & Neurology Specialization: Pain Medicine |
Allopathic & Osteopathic Physicians | ||
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 300018450U | 05 | |
| RAILROAD MEDICARE | CC1498 | 01 |
| Other Name | Type Code |
|---|---|
| Mercer Health Systems | Former Legal Business Name - Organization |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1550 College Street, Macon, GA 312071554 | 4783012397 | 4783012128 |
| Street Address |
250 MARTIN LUTHER KING JR BLVD |
| City | MACON |
| State | GA |
| Zip Code | 31201-3490 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669465860 | John Wesley King Jr. | Internal Medicine | 250 Martin Luther King Jr Blvd, Macon, GA 31201-3490 | 2005-08-24 |
| 1194350017 | Michael Caputo | Marriage & Family Therapist | 250 Martin Luther King Jr Blvd, Macon, GA 31201-3490 | 2020-03-11 |
| 1801319447 | Neha Khorana | Psychologist | 250 Martin Luther King Jr Blvd, Macon, GA 31201-3490 | 2017-07-25 |
| 1659818623 | Community Health Care Systems, Inc | Clinic/Center | 250 Martin Luther King Jr Blvd, Macon, GA 31201-3490 | 2017-01-27 |
| 1659716546 | Fanisha Y Porter | Psychiatry & Neurology | 250 Martin Luther King Jr Blvd, Macon, GA 31201 | 2013-05-06 |
| 1679835649 | Joe Sam Robinson IIi | Internal Medicine | 250 Martin Luther King Jr Blvd, Macon, GA 31201 | 2012-06-14 |
| 1831457274 | Stephanie Alexandra Beavers | Internal Medicine | 250 Martin Luther King Jr Blvd, Macon, GA 31201 | 2012-04-23 |
| 1447534441 | Marita Ann Hockstedler | Nurse Practitioner | 250 Martin Luther King Jr Blvd, Macon, GA 31201-0000 | 2011-10-10 |
| 1154602910 | Dinah K Ayna | Psychologist | 250 Martin Luther King Jr Blvd, Macon, GA 31201-3490 | 2011-09-07 |
| 1477708956 | Katherine Walker Hatcher | Nurse Practitioner | 250 Martin Luther King Jr Blvd, Macon, GA 31201-3490 | 2008-11-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639666340 | Yasameen Emad Muzahim | Internal Medicine | 777 Hemlock Street, Msc 165, Macon, GA 31201 | 2018-04-18 |
| 1952819419 | Putnam Dialysis LLC | Clinic/Center | 657 Hemlock Street, Suite 200, Macon, GA 31201 | 2018-01-18 |
| 1730604331 | Graham Arthur Mercier | Surgery | 169 Ashley Ave., Room 202 Main Hospital Msc 333, Charleston, SC 31201 | 2017-08-04 |
| 1376075705 | Diamond Jude | Internal Medicine | 777 Hemlock Street Msc #104, Macon, GA 31201 | 2017-04-03 |
| 1174055263 | Carol Roobin Bashuk | Hearing Instrument Specialist | 634 First Street, Macon, GA 31201 | 2017-03-29 |
| 1144752411 | Hubert Pare | Student in an Organized Health Care Education/Training Program | 777 Hemlock Street, Msc# 165, Macon, GA 31201 | 2017-03-28 |
| 1548613789 | Michael Daugherty | Counselor | 1873 Hardeman Ave, Suite 1, Macon, GA 31201 | 2016-07-22 |
| 1316317993 | 4front Healthcare of Middle Georgia, LLC | Hospice Care, Community Based | 682 1st St, Macon, GA 31201 | 2015-09-25 |
| 1881073054 | Andrew Lee Drahos | Surgery | 777 Hemlock St # 140, Macon, GA 31201 | 2015-05-21 |
| 1720474158 | April Nicole Colley | Nurse Practitioner | 1014 Forsyth Street, Macon, GA 31201 | 2015-04-13 |
| Find all providers in zip 31201 | ||||
| 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 |
|---|---|---|---|---|
| 1497393953 | Umerah Family Practice LLC | Family Medicine | 112 Arkwright Lndg Ste B, Macon, GA 31210-1364 | 2019-12-16 |
| 1992267892 | Andel Anthony Higgins | Family Medicine | 3780 Eisenhower Parkway, Macon, GA 31206 | 2019-04-01 |
| 1578025300 | Shail Patel | Family Medicine | 3780 Eisenhower Pkwy Ste 1, Macon, GA 31206-0801 | 2019-04-01 |
| 1972965226 | Omar Faruk Ahmad | Family Medicine | 3400 Riverside Drvie, Macon, GA 31210 | 2016-03-25 |
| 1255779351 | Kristopher K Mcjenkin | Family Medicine | 105 Bass Plantation Dr, Apt 607, Macon, GA 31210-5735 | 2013-06-11 |
| 1750620191 | Derrick Lane, Md, LLC | Family Medicine | 818 Forsyth St, Macon, GA 31201-2139 | 2013-02-05 |
| 1215182977 | Unlimited Medical Solutions, Inc. | Family Medicine | 3200 Riverside Dr Bldg B, Macon, GA 31210-2550 | 2008-11-22 |
| 1144474784 | Jack Fernando Menendez | Family Medicine | 376 Rogers Ave, Macon, GA 31204-2506 | 2008-11-10 |
| 1255504098 | Veera Pavuluri | Family Medicine | 132 Madison North Dr, Macon, GA 31220-7626 | 2008-04-11 |
| 1871770412 | Albert Warren Jr. | Family Medicine | 1339 Gray Hwy, Macon, GA 31211-1903 | 2008-01-25 |
| Find all providers in MACON | ||||
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| 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.