IM-PEDS PRIMARY CARE LLC
NPI 1578572293
Internal Medicine in Macon, GA

NPI Status: Active since August 05, 2006

Contact Information

360 HOSPITAL DR
BLDG D SUITE110
MACON, GA
ZIP 31217
Phone: (478) 841-2707
Fax: (478) 841-2708

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  • Organization
  • Internal Medicine
  • Accepts Insurance
  • CLIA Number: 11D0966861
  • CLIA Cert. Type: Physician Office
  • CLIA Exp. Date: 05-17-2027

About IM-PEDS PRIMARY CARE LLC

This page provides the complete NPI Profile along with additional information for Im-peds Primary Care Llc, an internist established in Macon, Georgia operating as a Internal Medicine. The healthcare provider is registered in the NPI registry with number 1578572293 assigned on August 2006. The practitioner's primary taxonomy code is 207R00000X with license number 051256 (GA). The provider is registered as an organization and their NPI record was last updated 7 years ago. Im-peds Primary Care Llc operates as a Multi-Specialty Group with one or more individual practitioners, who practice different areas of specialization. The authorized official of this NPI record is Mary Evelyn Mckinley Md (Doctor)

NPI
1578572293
Provider Name
IM-PEDS PRIMARY CARE LLC
Entity Type
Organization
Location Address
360 HOSPITAL DR BLDG D SUITE110 MACON, GA 31217
Location Phone
(478) 841-2707
Location Fax
(478) 841-2708
Mailing Address
360 HOSPITAL DR STE 110 MACON, GA 31217
Mailing Phone
(478) 841-2707
Mailing Fax
(478) 841-2708
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
08-05-2006
Last Update Date
02-11-2019
Code Navigator

An internist like Im-peds Primary Care Llc is a physician who has completed an internal medicine residency and is board-certified or board-eligible in an internist specialty. Internists are trained to care for adults of all ages for many different medical conditions. An internist typically monitors chronic physical conditions, identifies acute diseases, provides family planning, provides counseling about wellness and disease prevention, etc.

Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Internal Medicine

Taxonomy Code
207R00000X
Type
Allopathic & Osteopathic Physicians
License No.
051256
License State
GA
Taxonomy Description
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No. Taxonomy Code Type Classification /
Specialization
License No. (State)
1208000000XAllopathic & Osteopathic Physicians

Pediatrics

051256 (GA)

Group Taxonomy 193200000X MULTI-SPECIALTY GROUP

This provider is a business group of one or more individual practitioners, who practice with different areas of specialization.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • SoloCare Bronze EPO $8500 DED HSA 10004 - EPO
  • SoloCare Exp Bronze EPO $9500 DED 10015 - EPO
  • SoloCare Gold EPO $1500 DED 10010 - EPO
  • SoloCare Silver EPO $5000 DED 10014 - EPO
  • SoloCare Silver EPO $6500 DED 10013 - EPO
  • SoloCare Standard Exp Bronze EPO $7500 DED 10008 - EPO
  • SoloCare Standard Gold EPO $2000 DED 10006 - EPO
  • SoloCare Standard Platinum EPO $0 DED 10005 - EPO
  • SoloCare Standard Silver EPO $6000 DED 10007 - EPO
  • Elite Bronze - HMO
  • Elite Bronze + Vision + Adult Dental - HMO
  • Everyday Bronze - HMO
  • Everyday Bronze + Vision + Adult Dental - HMO
  • Focused Silver - HMO
  • Standard Expanded Bronze - HMO
  • Standard Gold - HMO
  • Standard Silver - HMO
  • Standard Silver + Vision + Adult Dental - HMO
  • Clarity Silver - HMO
  • Complete Gold - HMO
  • Complete Gold + Vision + Adult Dental - HMO
  • Elite Bronze - HMO
  • Elite Bronze + Vision + Adult Dental - HMO
  • Enhanced Diabetes Care Silver with $0 Drug Options - HMO
  • Enhanced Diabetes Care Silver with $0 Drug Options + Vision + Adult Dental - HMO
  • Everyday Bronze - HMO
  • Everyday Bronze + Vision + Adult Dental - HMO
  • Everyday Gold - HMO
  • Complete Gold - EPO
  • Complete Gold + Vision + Adult Dental - EPO
  • Elite Bronze - EPO
  • Elite Bronze + Vision + Adult Dental - EPO
  • Elite Gold - EPO
  • Elite Gold + Vision + Adult Dental - EPO
  • Enhanced Diabetes Care Silver with $0 Drug Options - EPO
  • Enhanced Diabetes Care Silver with $0 Drug Options + Vision + Adult Dental - EPO
  • Everyday Bronze - EPO
  • Everyday Bronze + Vision + Adult Dental - EPO
  • Clear Silver with $0 Insulin Options - HMO
  • Complete Gold - HMO
  • Complete Gold + Vision + Adult Dental - HMO
  • Complete Gold with Atrium Health - HMO
  • Complete Gold with Atrium Health + Vision + Adult Dental - HMO
  • Elite Bronze - HMO
  • Elite Bronze + Vision + Adult Dental - HMO
  • Elite Bronze with Atrium Health - HMO
  • Elite Bronze with Atrium Health + Vision + Adult Dental - HMO
  • Enhanced Asthma/COPD Care Silver with $0 Drug Options - HMO
  • Elite Bronze - EPO
  • Elite Bronze + Vision + Adult Dental - EPO
  • Elite Gold - EPO
  • Elite Gold + Vision + Adult Dental - EPO
  • Enhanced Diabetes Care Silver with $0 Drug Options - EPO
  • Enhanced Diabetes Care Silver with $0 Drug Options + Vision + Adult Dental - EPO
  • Everyday Bronze - EPO
  • Everyday Bronze + Vision + Adult Dental - EPO
  • Everyday Gold - EPO
  • Everyday Gold + Vision + Adult Dental - EPO

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

MARY EVELYN MCKINLEY MD

Authorized Official Title
DOCTOR
Authorized Official Phone
(478) 841-2707

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
000954005AMEDICAID (05)GA 
DF1259OTHER (01)GARAILROAD MEDICARE

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
11D0966861
Facility Type
Physician Office
Certificate Effective Date
May 18, 2025
Certificate Expiration Date
May 17, 2027
Laboratory Director
MARY EVELYN MCKINLEY
Certificate Type
Certificate of Compliance
Certificate Type Description
This CLIA certificate is issued to Im-peds Primary Care Llc after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements. This type of certificate is issued to laboratories that perform nonwaived (moderate and/or high complexity) testing.

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1578572293, we treat the final digit (3) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 67. The final step is to find the difference between that total and the next multiple of ten (70 - 67 = 3).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
5
Unchanged
Pos 3
7
Doubled → 14 → 1 + 4
Pos 4
8
Unchanged
Pos 5
5
Doubled → 10 → 1 + 0
Pos 6
7
Unchanged
Pos 7
2
Doubled → 4
Pos 8
2
Unchanged
Pos 9
9
Doubled → 18 → 1 + 8
Check
3
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 7 → 14 → 5 5 → 10 → 1 2 → 4 9 → 18 → 9

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 5 + 1 + 4 + 8 + 1 + 0 + 7 + 4 + 2 + 1 + 8 + 24 = 67

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 67 is 70. The difference is the calculated check digit.

70 - 67 = 3
This NPI is valid
The calculated check digit is 3, which matches the last digit of 1578572293.

Other Providers at the Same Location


The following 8 providers are registered at the same or a nearby location.

Internal Medicine
360 HOSPITAL DR, SUITE 110
MACON, GA 31217
Internal Medicine (Cardiovascular Disease)
360 HOSPITAL DR, BLDG D, STE 200
MACON, GA 31217
Nurse Practitioner
360 HOSPITAL DR, BLDG. D, SUITE 200
MACON, GA 31217
Nurse Practitioner (Primary Care)
360 HOSPITAL DR, SUITE 110D
MACON, GA 31217
Nurse Practitioner (Family)
360 HOSPITAL DR, BUILDING D SUITE 110
MACON, GA 31217
Internal Medicine
360 HOSPITAL DR, BLDG D SUITE 120
MACON, GA 31217
Internal Medicine
360 HOSPITAL DR, SUITE 110
MACON, GA 31217
Clinic/Center (Multi-Specialty)
360 HOSPITAL DR, BUILDING D, SUITE 130
MACON, GA 31217

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1578572293, enumerated as an "organization" on August 05, 2006.

The provider is located at 360 HOSPITAL DR BLDG D SUITE110 MACON, GA 31217 and the phone number is (478) 841-2707.

Internal Medicine with taxonomy code 207R00000X.

The provider might be accepting Accepts: Alliant Health Plans, Inc., Ambetter from Absolute. Please consult your insurance carrier or call the provider to verify.