NPIMap

Organization Active NPI

Tift County Hospital Authority

Doing business as Fitzgerald Primary Care

  • Family Medicine Physician
  • Fitzgerald, GA
National Provider Identifier
1013315605
Registry record updated Dec 12, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
030071 Issued in GA
Legal business name
TIFT COUNTY HOSPITAL AUTHORITY
Doing business as
Fitzgerald Primary Care
Practice address
246 Ben Hill Drive
Fitzgerald, GA 31750
Phone
(229) 423-2400
Fax
(229) 423-2472
NPI assigned
Dec 12, 2014
Last updated
Dec 12, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2014

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

Authorized official

Name
Linda A Wilson
Title
VP Physician Services
Phone
(229) 353-3403

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 030071 GA Primary

Addresses

Primary practice location

246 Ben Hill Drive
Fitzgerald, GA 31750

Mailing address

907 18TH St E
Suite 150
Tifton, GA 31794-3643
Phone (229) 423-2400

Other names 1

  • Fitzgerald Primary Care Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Tift Regional Health System Inc19 organizations share this tax ID, including this one

Other organizations with this tax ID 18

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

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1418342400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1418342400000",
    "number": "1013315605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "907 18TH ST E",
            "address_2": "SUITE 150",
            "city": "TIFTON",
            "state": "GA",
            "postal_code": "317943643",
            "telephone_number": "229-423-2400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "246 BEN HILL DRIVE",
            "city": "FITZGERALD",
            "state": "GA",
            "postal_code": "31750",
            "telephone_number": "229-423-2400",
            "fax_number": "229-423-2472"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TIFT COUNTY HOSPITAL AUTHORITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-12-12",
        "last_updated": "2014-12-12",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "LINDA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "VP PHYSICIAN SERVICES",
        "authorized_official_telephone_number": "229-353-3403"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "030071",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fitzgerald Primary Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fitzgerald, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.