NPIMap

Organization Active NPI

Hospital Authority of Valdosta and Lowndes County Georgia

Doing business as Greenleaf Center

  • Psychiatric Hospital Unit
  • Valdosta, GA
National Provider Identifier
1033160791
Registry record updated May 9, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric Hospital UnitTaxonomy code 273R00000X
License
92141 Issued in GA
Legal business name
HOSPITAL AUTHORITY OF VALDOSTA AND LOWNDES COUNTY GEORGIA
Doing business as
Greenleaf Center
Practice address
2209 Pineview Dr
Valdosta, GA 31602-7316
Phone
(229) 247-4357
Fax
(229) 244-6194
NPI assigned
May 15, 2006
Last updated
May 9, 2011By the provider in NPPES
Organization subpart
Yes
Parent organization
HOSPITAL AUTHORITY OF VALDOSTA AND LOWNDES COUNTY GEORGIAAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 9, 2011

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

Authorized official

Name
Mr. Greg S Hembree
Title
Chief Financial Officer
Phone
(229) 259-4160

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Mental Health Clinic/Center 261QM0850X 92141 GA
Adolescent and Children Mental Health Clinic/Center 261QM0855X 92141 GA
Psychiatric Hospital Unit 273R00000X 92141 GA Primary

Addresses

Primary practice location

2209 Pineview Dr
Valdosta, GA 31602-7316

Mailing address

PO Box 0070
Attn: PFS Dept
Valdosta, GA 31603-0070
Phone (229) 247-4357

Other identifiers 2

IdentifierTypeStateIssuer
HOSP24OtherGACAHABA
00001724AMedicaidGA

Other names 1

  • Greenleaf Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040405001313 GA Part B Supplier - Clinic/Group Practice 1355334509 Receives reassigned benefits from 114 practitioners
13 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Valdosta, GA; Nashville, GA; Lakeland, GA

Other NPIs on the same Medicare enrollment 13

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 13

National Provider Directory

National Provider Directory
Part of
Southe Georgia Medical

Practitioners & affiliated clinicians

Practitioners 114

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 114

NPI Registry JSON

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

{
    "created_epoch": "1147651200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1304899200000",
    "number": "1033160791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 0070",
            "address_2": "ATTN: PFS DEPT",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316030070",
            "telephone_number": "229-247-4357",
            "fax_number": "229-244-6194"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2209 PINEVIEW DR",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316027316",
            "telephone_number": "229-247-4357",
            "fax_number": "229-244-6194"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOSPITAL AUTHORITY OF VALDOSTA AND LOWNDES COUNTY GEORGIA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "HOSPITAL AUTHORITY OF VALDOSTA AND LOWNDES COUNTY GEORGIA",
        "enumeration_date": "2006-05-15",
        "last_updated": "2011-05-09",
        "status": "A",
        "authorized_official_last_name": "HEMBREE",
        "authorized_official_first_name": "GREG",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "229-259-4160",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "GA",
            "license": "92141",
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": "GA",
            "license": "92141",
            "primary": false
        },
        {
            "code": "273R00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Unit",
            "state": "GA",
            "license": "92141",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAHABA",
            "identifier": "HOSP24",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00001724A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Greenleaf Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Valdosta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.