NPIMap

Organization Active NPI

Athens Model Neighborhood Health Center Inc

Doing business as Hillsman Health Center

  • Federally Qualified Health Center (FQHC)
  • Athens, GA
National Provider Identifier
1053962902
Registry record updated Aug 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
ATHENS MODEL NEIGHBORHOOD HEALTH CENTER INC
Doing business as
Hillsman Health Center
Practice address
870 Gaines School Rd
Athens, GA 30605-3132
Phone
(762) 499-6960
NPI assigned
Sep 23, 2019
Last updated
Aug 4, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
HILLSMAN HEALTH CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 4, 2023

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

Authorized official

Name
Linda M Cherry
Title
Human Resource
Phone
(762) 499-6960

Specialties & licenses 1

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

Addresses

Primary practice location

870 Gaines School Rd
Athens, GA 30605-3132

Mailing address

PO Box 147
Athens, GA 30603-0147
Phone (762) 499-6960

Other names 1

  • Hillsman Health Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040525001064 GA Part B Supplier - Clinic/Group Practice 0042291270 Receives reassigned benefits from 15 practitioners
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Athens, GA

Other NPIs on the same Medicare enrollment 2

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

National Provider Directory

National Provider Directory
Tax ID family
Athens Neighborhood HLT3 organizations share this tax ID, including this one
Part of
Athens Neighborhood HLT

Other organizations with this tax ID 2

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

Locations

3320 Old Jefferson Rd
Ste 300D
Athens, GA 30607
Phone (706) 850-9041

870 Gaines School Rd
Athens, GA 30605
Phone (706) 546-7463

Practitioners & affiliated clinicians

Practitioners 15

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 15

NPI Registry JSON

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

{
    "created_epoch": "1569196800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1691107200000",
    "number": "1053962902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 147",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "306030147",
            "telephone_number": "762-499-6960",
            "fax_number": "706-850-9047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "870 GAINES SCHOOL RD",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "306053132",
            "telephone_number": "762-499-6960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ATHENS MODEL NEIGHBORHOOD HEALTH CENTER INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "HILLSMAN HEALTH CENTER",
        "enumeration_date": "2019-09-23",
        "last_updated": "2023-08-04",
        "certification_date": "2023-08-04",
        "status": "A",
        "authorized_official_last_name": "CHERRY",
        "authorized_official_first_name": "LINDA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "HUMAN RESOURCE",
        "authorized_official_telephone_number": "762-499-6960"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hillsman Health Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Hillsman Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Athens, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2023; 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.