NPIMap

Organization Active NPI

Glascock County Board of Health

Doing business as Glascock County Health Department

  • Public Health or Welfare Agency
  • Gibson, GA
National Provider Identifier
1073242103
Registry record updated Mar 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Public Health or Welfare AgencyTaxonomy code 251K00000X
Legal business name
GLASCOCK COUNTY BOARD OF HEALTH
Doing business as
Glascock County Health Department
Practice address
658 W Main St
Gibson, GA 30810-4013
Phone
(706) 598-2061
Fax
(706) 598-2442
NPI assigned
Jun 6, 2022
Last updated
Mar 5, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2024

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

Authorized official

Name
Lee Ann Donohue, MD
Title
District Health Director
Phone
(706) 825-6914

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Public Health or Welfare Agency 251K00000X NU Primary

Addresses

Primary practice location

658 W Main St
Gibson, GA 30810-4013

Mailing address

PO Box 98
Gibson, GA 30810-0098
Phone (706) 598-2061

Other names 1

  • Glascock County Health Department Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220620000503 GA Part B Supplier - Clinic/Group Practice 9436384898 Receives reassigned benefits from 2 practitioners
Practice locations: Gibson, GA

Other NPIs with the same Medicare PAC ID 1

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

National Provider Directory

National Provider Directory
Tax ID family
East Central Health District2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Practitioners & affiliated clinicians

Practitioners 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1654473600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1709596800000",
    "number": "1073242103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 98",
            "city": "GIBSON",
            "state": "GA",
            "postal_code": "308100098",
            "telephone_number": "706-598-2061",
            "fax_number": "706-598-2442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "658 W MAIN ST",
            "city": "GIBSON",
            "state": "GA",
            "postal_code": "308104013",
            "telephone_number": "706-598-2061",
            "fax_number": "706-598-2442"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLASCOCK COUNTY BOARD OF HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-06-06",
        "last_updated": "2024-03-05",
        "certification_date": "2024-02-22",
        "status": "A",
        "authorized_official_last_name": "DONOHUE",
        "authorized_official_first_name": "LEE",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "DISTRICT HEALTH DIRECTOR",
        "authorized_official_telephone_number": "706-825-6914",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Glascock County Health Department",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Glascock County Health Department",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Gibson, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2024; 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.