NPIMap

Organization Active NPI

Curtis V. Cooper Primary Health Care Inc.

  • Federally Qualified Health Center (FQHC)
  • Springfield, GA
National Provider Identifier
1023804150
Registry record updated Apr 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
CURTIS V. COOPER PRIMARY HEALTH CARE INC.
Practice address
1451 Ga Highway 21 S Ste H
Springfield, GA 31329-5244
Phone
(912) 527-1000
NPI assigned
Apr 16, 2025
Last updated
Apr 16, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2025

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

Authorized official

Name
Earlene Joiner Daniels
Title
Cfo
Phone
(912) 527-1088

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

1451 Ga Highway 21 S Ste H
Springfield, GA 31329-5244

Mailing address

106 E Broad St
Savannah, GA 31401-2917
Phone (912) 527-1000

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250505001918 GA Part A Provider - Federally Qualified Health Center (FQHC) 4789667015 Practice locations: Springfield, GA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1023804150. Details of each certification follow.

Federally qualified health center certification: CCN C21040

Legal name
CURTIS V. COOPER PRIMARY HEALTH CARE, INC.
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Apr 18, 2025
Last certification
Apr 18, 2025
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Enrollment address
1451 Ga Highway 21 S
Ste H
Springfield, GA 31329-5244

Other NPIs with the same Medicare PAC ID 12

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

National Provider Directory

National Provider Directory
Tax ID family
Curtis V Cooper Primary Hea16 organizations share this tax ID, including this one

Other organizations with this tax ID 15

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

View all 15

Ownership & related parties

All disclosed owners & managing parties 8

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

NameRoleSinceShare
Paul Mosley Individual Corporate DirectorBoard Member Jan 1, 2019
Juliet Wade Individual Corporate DirectorBoard Member Jan 1, 2012
Larry Jackson Individual Corporate DirectorBoard Member Jan 1, 2014
Albert Grandy Individual Corporate DirectorCeo Aug 1, 2013
Earlene J Daniels Individual Corporate OfficerCfo Jan 1, 2018
Corporate Director Jan 1, 2014
W-2 Managing EmployeeCfo Jan 1, 2018
Operational/Managerial Control Jan 1, 2020 100%
Helen Stone Individual Corporate DirectorBoard Member Jan 1, 2014
Reginald Franklin Individual Corporate DirectorBoard Member Jan 1, 2012
Mary Hill Individual Corporate DirectorBoard Member Jan 1, 2021

Practitioners & affiliated clinicians

Practitioners 74

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 74

NPI Registry JSON

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

{
    "created_epoch": "1744761600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1744761600000",
    "number": "1023804150",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 E BROAD ST",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314012917",
            "telephone_number": "912-527-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1451 GA HIGHWAY 21 S STE H",
            "city": "SPRINGFIELD",
            "state": "GA",
            "postal_code": "313295244",
            "telephone_number": "912-527-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CURTIS V. COOPER PRIMARY HEALTH CARE INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-04-16",
        "last_updated": "2025-04-16",
        "certification_date": "2025-04-16",
        "status": "A",
        "authorized_official_last_name": "DANIELS",
        "authorized_official_first_name": "EARLENE",
        "authorized_official_middle_name": "JOINER",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "912-527-1088"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, GA

Sources for this page

Verify at the official NPI Registry.