NPIMap

Organization Active NPI

Geneva County Healthcare Authority Inc

Doing business as Wiregrass Medical Center

  • Certified Registered Nurse Anesthetist
  • Geneva, AL
National Provider Identifier
1003943531
Registry record updated Nov 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
Legal business name
GENEVA COUNTY HEALTHCARE AUTHORITY INC
Doing business as
Wiregrass Medical Center
Practice address
1200 W Maple Ave
Geneva, AL 36340
Phone
(334) 684-3655
Fax
(334) 684-6564
NPI assigned
Feb 28, 2007
Last updated
Nov 13, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mrs. Janet Smith
Title
Ceo
Phone
(334) 684-3655

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medical Services (Emergency Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207PE0004X 11807 AL
Certified Registered Nurse AnesthetistGroup: 193200000X MULTI-SPECIALTY GROUP 367500000X Primary

Addresses

Primary practice location

1200 W Maple Ave
Geneva, AL 36340

Mailing address

1200 W Maple Ave
Geneva, AL 36340-1642
Phone (334) 684-3655

Other names 1

  • WIREGRASS MEDICAL CENTER Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190206002405 AL Part B Supplier - Clinic/Group Practice 0244222487 Receives reassigned benefits from 3 practitioners
Practice locations: Geneva, AL

Other NPIs with the same Medicare PAC ID 5

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Wiregrass Hospital and8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

All facility ownership & control disclosures 3

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Wiregrass Medical CenterGeneva, AL, CCN 011309 Hospital 5% Or Greater Direct Ownership Interest (100%) Oct 17, 2013
Wiregrass Medical CenterGeneva, AL, CCN 01Z309 Hospital 5% Or Greater Direct Ownership Interest (100%) Oct 17, 2013
Samson Rural Health ClinicSamson, AL, CCN 018502 Rural health clinic 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Nov 1, 2019
Nov 1, 2019

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 21

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 21

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1172620800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1731456000000",
    "number": "1003943531",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 W MAPLE AVE",
            "city": "GENEVA",
            "state": "AL",
            "postal_code": "363401642",
            "telephone_number": "334-684-3655",
            "fax_number": "334-684-6564"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 W MAPLE AVE",
            "city": "GENEVA",
            "state": "AL",
            "postal_code": "36340",
            "telephone_number": "334-684-3655",
            "fax_number": "334-684-6564"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENEVA COUNTY HEALTHCARE AUTHORITY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-28",
        "last_updated": "2024-11-13",
        "certification_date": "2024-11-13",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "JANET",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "334-684-3655",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207PE0004X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "AL",
            "license": "11807",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "WIREGRASS MEDICAL CENTER",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "WIREGRASS MEDICAL CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Geneva, AL

Sources for this page

Verify at the official NPI Registry.