Neighborhood Improvement Project Inc
Organization Active NPI Federally Qualified Health Center (FQHC) · Waynesboro, GA
NPI 1043961980 · NPPES record last updated Jan 12, 2022
Key facts
- NPI
- 1043961980
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Federally Qualified Health Center (FQHC) 261QF0400X
- Legal business name
- NEIGHBORHOOD IMPROVEMENT PROJECT INC
- Practice address
- 500 Park Dr BLDG 3
Waynesboro, GA 30830-1625 - Phone
- (762) 783-0301
- Fax
- (762) 783-0302
- NPI assigned
- Jan 12, 2022
- Organization subpart
- No
Authorized official
- Name
- Wesley Wood
- Title
- Cfo
- Phone
- (706) 790-4440
Owners & managing parties with NPI records 24
Owned or controlled facilities with NPI records 8
Other NPIs on the same Medicare enrollment 6
Other NPIs with the same Medicare PAC ID 24
Corporate family (same tax ID) 33
Facilities with the same owner 7
Practitioners 68
-
Jose H Acevedo, M.D.
-
Evan C Bahr, MD
-
Tara Roychell Blair, APRN
-
Veronica Bradford, APRN
-
Samuel Edward Burkett, M.D.
-
Raisa Mary Colon, NP
-
Kepler Austin Davis, M.D.
-
Alan Joseph Deangelo, M.D.
-
Ketki Desai, MD
-
Mallika Devarapalli, D.O.
-
Alice Kimberly Duffey, FNP-BC
-
Silvia Heidi Dunn, FNP-C
-
Leyla El-Choufi, M.D.
-
Bie Mende Etinge, DO
-
James Milton Ford, M.D.
-
Carlos Foster, LCSW
-
Jones Mark Gresham, M.D.
-
George S Havrilla, DPM
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in GA
Federally qualified health center certification: CCN 851162
- Legal name
- NEIGHBORHOOD IMPROVEMENT PROJECT, INC
- Certification status
- Active
- Provider type (POS)
- Federally qualified health center
- Participating since
- Feb 4, 2022
- Last certification
- Feb 4, 2022
- Ownership / control type
- For profit – corporation
- Organization structure
- Corporation · Non-profit
- Incorporated
- Jan 7, 2022 in GA
- Enrollment address
- 500 Park Dr
BLDG 3
Waynesboro, GA 30830-1625
All disclosed owners & managing parties 11
| Name | Role | Since | Share |
|---|---|---|---|
| Melvin Lowry |
Other | Dec 5, 2007 | |
| Janice Bailey |
Other | Dec 5, 2007 | |
| Angela Goodwin |
Other | Dec 5, 2007 | |
| Willie Saunders |
Other | Dec 5, 2007 | |
| Neighborhood Improvement Project, Inc |
Operational/Managerial Control | Jan 7, 2022 | |
| James Williams |
Other | Dec 5, 2007 | |
| Wesley Wood |
Corporate Officer |
Jan 1, 2015 | |
| Operational/Managerial Control |
Jan 1, 2015 | ||
| Francine Holmes |
Other | Dec 5, 2007 | |
| Nancy Ross |
Other | Dec 5, 2007 | |
| Willie Jones |
Other | Dec 5, 2007 | |
| Barbara Washington |
Other | Dec 5, 2007 |
All facility ownership & control disclosures 8
| Facility | Type | Role | Since |
|---|---|---|---|
| Medical Associates Plus at Wrens |
Federally qualified health center | Operational/Managerial Control | Dec 1, 2013 |
| Neighborhood Improvement Project, Inc |
Federally qualified health center | 5% Or Greater Direct Ownership Interest (100%) | Jan 1, 2016 |
| Medical Associates Plus |
Federally qualified health center | Operational/Managerial Control | Jan 1, 2016 |
| Medical Associates Plus |
Federally qualified health center | Operational/Managerial Control (100%) | Apr 1, 2022 |
| Medical Associates Plus |
Federally qualified health center | Operational/Managerial Control | Jul 1, 2022 |
| Medical Associates Plus |
Federally qualified health center | Operational/Managerial Control | Oct 1, 2022 |
| Medical Associates Plus |
Federally qualified health center | Operational/Managerial Control | Jan 1, 2023 |
| Medical Associates Plus |
Federally qualified health center | Other | Dec 1, 2024 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20031117000665 | GA | Part B Supplier - Clinic/Group Practice | 7315851078 |
Receives reassigned benefits from 103 practitioners 6 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Evans, GA; Keysville, GA; Lincolnton, GA; Thomson, GA; Waynesboro, GA; Wrens, GA; Augusta, GA |
| O20220316004077 | GA | Part a Provider - Federally Qualified Health Center (FQHC) | 7315851078 | Practice locations: Waynesboro, GA |
National Provider Directory
- Tax ID family
- Neighborhood Improvement Project
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Federally Qualified Health Center (FQHC) | 261QF0400X | Yes |
Addresses
Primary practice location
500 Park Dr BLDG 3
Waynesboro, GA 30830-1625
Mailing address
2467 Golden Camp Rd
Augusta, GA 30906-5515
Phone (706) 790-4440
Other providers in Waynesboro, GA
- Robin Dubose Mizell
- Dontae Morgan
- Jessica Brianne Moritz
- Charles Graybill Moye Sr.
- Varan Mungin
- Neighborhood Improvement Project Inc
- Neighborhood Improvement Project Inc
- Neighborhood Improvement Project, Inc
- Nephrology Centers of America LLC
- Nephrology Centers of America, LLC
All providers in Waynesboro, GA · Federally Qualified Health Center (FQHC) in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 12, 2022. 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.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.