Ben Hill Emergency Group LLC
Organization Active NPI Emergency Medicine Physician · Fitzgerald, GA
NPI 1043328156 · NPPES record last updated Feb 16, 2016
Key facts
- NPI
- 1043328156
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Emergency Medicine Physician 207P00000X
- Legal business name
- BEN HILL EMERGENCY GROUP LLC
- Practice address
- 200 Perry House Rd
Fitzgerald, GA 31750-8857 - Phone
- (800) 893-9698
- NPI assigned
- Aug 28, 2006
- Organization subpart
- No
Authorized official
- Name
- Lisha C Falk
- Title
- VP of Contracting
- Phone
- (800) 893-9698
Practitioners 24
-
George U Amah, MD
-
Paul Chukelu, M.D. M.P.H
-
Brian K. Jordan, D.O.
-
Robert B Little, M.D.
-
Vijay K. Mahathre, M.D.
-
Michael R. Nulph, M.D.
-
Pearlie Peterson-Cornett, D.O.
-
Jeffery Thomas Winge, M.D.
-
Babak Saadatmand, MD
-
Gregory Whatley, M.D.
-
Thomas Roy White, D.O.
-
Bruce S. Whitman, D.O.
-
Mary Bourque, MOT, LOTR
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20061025000232 | GA | Part B Supplier - Clinic/Group Practice | 3274530837 |
Receives reassigned benefits from 23 practitioners Practice locations: Fitzgerald, GA |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician |
207P00000X | Yes | ||
| Medical Physician Assistant |
363AM0700X | |||
| Nurse Practitioner |
363L00000X |
Addresses
Primary practice location
200 Perry House Rd
Fitzgerald, GA 31750-8857
Mailing address
200 Corporate Blvd
Lafayette, LA 70508-3870
Phone (800) 893-9896
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 708665600A | Medicaid | GA |
Other names
- DORMINY MEDICAL CENTER
Other providers in Fitzgerald, GA
- American Home Medical Equipment LLC
- Ankle & Foot Associates, LLC
- Katy Bailey
- Ben Hill County EMS
- Ben Hill County School System
- Ben Hill Family Medicine
- Ben Hill Health Care Center, Inc.
- Ben Hill Mental Retardation Service
- Ben Hill Physician Services LLC
- Best Hands Services LLC.
All providers in Fitzgerald, GA · Emergency Medicine Physician in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 16, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.