LACANILAO MEDICAL MANAGEMENT PC (NPI# 1477698611) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1477698611 |
| Entity Type | Organization |
| Organization Name | LACANILAO MEDICAL MANAGEMENT PC |
| Other Organization Name | KINGS BAY FAMILY CARE |
| Practice Address |
340 Charlie Smith Sr Hwy Saint Marys GA 31558-3101 |
| Practice Telephone | 9128825030 |
| Practice Fax Number | 8884765235 |
| Mailing Telephone | 9128825030 |
| Mailing Fax Number | 8884765235 |
| Enumeration Date | 2007-02-21 |
| Last Update Date | 2012-12-20 |
| Authorized Official Name | DR. ANGELITO BUENCAMINO LACANILAO (PRESIDENT) |
| Authorized Official Telephone | 9128825030 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 052769 | GA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | MEDICARE PTAN | GRP6277 | 01 |
| GA | 083558714B | 05 | |
| GA | NPI | 1477698611 | 01 |
| Other Name | Type Code |
|---|---|
| Kings Bay Family Care | Doing Business As Name - Organization |
| Street Address |
340 CHARLIE SMITH SR HWY |
| City | SAINT MARYS |
| State | GA |
| Zip Code | 31558-3101 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659416956 | Angelito Buencamino Lacanilao | Family Medicine | 340 Charlie Smith Sr Hwy, Saint Marys, GA 31558-3101 | 2007-02-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942827332 | Primary Care of Coastal Georgia | Clinic/Center | 214a Professional Cir, St Marys, GA 31558 | 2020-07-01 |
| 1922659192 | Christian Bianca Booker | Social Worker | 944 Kings Bay Rd. #247, St. Marys, GA 31558 | 2019-09-27 |
| 1154897296 | Shonta Harper | Counselor | 708 Osborne St Ste 104, Saint Marys, GA 31558 | 2018-10-16 |
| 1174038095 | Camden Behavioral Wellness, Inc | Counselor | 605 Osborne Street, Saint Mary's, GA 31558 | 2017-12-14 |
| 1285149427 | Urgent Care of Coastal Georgia | General Practice | 214 A Professional Circle, St. Marys, GA 31558 | 2017-12-11 |
| 1679975783 | Jeremy Cole | Behavioral Analyst | 921 Charlie Smith Sr. Highway, St. Marys, GA 31558 | 2014-09-19 |
| 1053660738 | Janice Paulino Ramirez | Nurse Practitioner | 2040 Dan Proctor Drive, Suite 170, St Marys, GA 31558 | 2012-09-10 |
| 1174899454 | Light Horse Healthcare Inc | Voluntary or Charitable | 2060 Dan Proctor Drive, Suite 3300, St Marys, GA 31558 | 2012-03-30 |
| 1316215775 | Annette O. Perry | Counselor | 4019 Hwy 40 East, St. Marys, GA 31558 | 2011-12-13 |
| 1932486271 | Sarah Jo Meyers | Speech-Language Pathologist | 2015 Osborne Rd, Unit A, St Marys, GA 31558 | 2011-11-15 |
| Find all providers in zip 31558 | ||||
| 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 |
|---|---|---|---|---|
| 1689855660 | Baptist Primary Care Inc | Family Medicine | 2060 Dan Proctor Dr Ste 3100, Saint Marys, GA 31558-4324 | 2007-11-19 |
| 1649465667 | Continium Care Solutions Inc | Family Medicine | 944 Kingsbay Rd Ste A, Suite 117, Saint Marys, GA 31558-3755 | 2007-09-12 |
| 1982816047 | Longevity Care Services Inc | Family Medicine | 4445 Ga Highway 40 E, Suite 503, Saint Marys, GA 31558-4099 | 2007-05-03 |
| 1245389568 | Cornerstone Health Care Inc. | Family Medicine | 201 Lafayette St, Saint Marys, WV 26170-1027 | 2007-01-09 |
| 1053401133 | Dennis W Rhoades | Family Medicine | 757 Johnsonburg Rd, Ground Floor Rehab Building, Saint Marys, PA 15857-3488 | 2006-10-13 |
| 1023113693 | Padmaja Chalasani | Family Medicine | 1300 Greenville Rd, Saint Marys, OH 45885-2600 | 2006-09-14 |
| 1114980547 | Dawn P Mcnaughton | Family Medicine | 1040 Hager St, Saint Marys, OH 45885-2421 | 2006-04-07 |
| 1881653053 | Ryan J Minnich | Family Medicine | 1100 Million Dollar Hwy, Saint Marys, PA 15857-2728 | 2006-03-17 |
| 1982684411 | David B Jones | Family Medicine | 515 W Bertrand Ave, Saint Marys, KS 66536-1618 | 2006-01-19 |
| 1225025430 | Rosemaria Judith Cienciva | Family Medicine | Erpg Keystone Medical Associates, 136 State Street, Saint Marys, PA 15857-1626 | 2005-10-03 |
| Find all providers in SAINT MARYS | ||||
| City | SAINT MARYS |
| Zip Code | 31558 |
Please comment or provide details below to improve the information on LACANILAO MEDICAL MANAGEMENT PC.
| 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.