NPIMap

Organization Active NPI

Georgia Mountains Health Services, Inc.

  • Federally Qualified Health Center (FQHC)
  • Blue Ridge, GA
National Provider Identifier
1013776442
Registry record updated May 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
GEORGIA MOUNTAINS HEALTH SERVICES, INC.
Practice address
79 Blue Ridge Overlook
Blue Ridge, GA 30513-4478
Phone
(706) 374-3100
Fax
(706) 374-7628
NPI assigned
Mar 18, 2024
Last updated
May 4, 2026By the provider in NPPES
Organization subpart
Yes
Parent organization
GEORGIA MOUNTAINS HEALTH SERVICES, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on May 4, 2026

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

Authorized official

Name
Andrew Stewart
Title
Ceo
Phone
(706) 946-5600

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X NU Primary
Urgent Care Clinic/Center 261QU0200X NU

Addresses

Primary practice location

79 Blue Ridge Overlook
Blue Ridge, GA 30513-4478

Mailing address

165 Blue Ridge Overlook
Blue Ridge, GA 30513-4431
Phone (706) 956-5607

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20241226000069 GA Part A Provider - Federally Qualified Health Center (FQHC) 7719974831 Practice locations: Blue Ridge, GA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1013776442. Details of each certification follow.

Federally qualified health center certification: CCN C21025

Legal name
GEORGIA MOUNTAINS HEALTH SERVICES, INC.
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Dec 4, 2024
Last certification
Dec 4, 2024
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Enrollment address
79 Blue Ridge Overlook
Blue Ridge, GA 30513-4478

Other NPIs with the same Medicare PAC ID 8

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

National Provider Directory

National Provider Directory
Tax ID family
Georgia Mountns HLTH11 organizations share this tax ID, including this one
Part of
Georgia Mountns HLTH

Other organizations with this tax ID 10

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

Locations

165 Blue Ridge Overlook
Blue Ridge, GA 30513
Phone (706) 946-4647

1008 N 3rd Ave
Chatsworth, GA 30705
Phone (706) 517-2273

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/20104/brand/1/csg/1/fhir/r4

Ownership & related parties

All disclosed owners & managing parties 12

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
John Thomas Individual Corporate DirectorBoard Member Mar 25, 2024
Steven Miracle Individual Corporate DirectorCeo Jun 12, 2003 100%
Operational/Managerial ControlCeo Jun 12, 2003 100%
Sheila Wilson Individual Corporate DirectorBoard Member May 20, 2024
Melissa P Sneads Individual Corporate DirectorBoard Member Feb 17, 2021
Deborah S Peterson Individual Corporate DirectorBoard Member Jan 1, 2012
Randy Westbrook Individual Corporate OfficerCfo Sep 29, 2008
John H Rhodes Individual Corporate DirectorBoard Member Jul 25, 2011
Ronald Stan Bafile Individual Corporate DirectorBoard Member Mar 8, 2022
Marvin Chance Individual Corporate DirectorBoard Member Jul 6, 2018
Patricia a Hampton Individual Corporate DirectorBoard Member Apr 26, 2010
Lloyd Gamison Phillips Individual Corporate DirectorBoard Member Jan 12, 2010
Bianca Whittenbarger Individual Corporate DirectorBoard Member May 1, 2014

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1710720000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1777852800000",
    "number": "1013776442",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "165 BLUE RIDGE OVERLOOK",
            "city": "BLUE RIDGE",
            "state": "GA",
            "postal_code": "305134431",
            "telephone_number": "706-956-5607",
            "fax_number": "706-374-7628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "79 BLUE RIDGE OVERLOOK",
            "city": "BLUE RIDGE",
            "state": "GA",
            "postal_code": "305134478",
            "telephone_number": "706-374-3100",
            "fax_number": "706-374-7628"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GEORGIA MOUNTAINS HEALTH SERVICES, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GEORGIA MOUNTAINS HEALTH SERVICES, INC.",
        "enumeration_date": "2024-03-18",
        "last_updated": "2026-05-04",
        "certification_date": "2026-05-04",
        "status": "A",
        "authorized_official_last_name": "STEWART",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "706-946-5600"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Blue Ridge, GA

Sources for this page

Verify at the official NPI Registry.