NGMC Lumpkin, LLC
Organization Active NPI General Acute Care Hospital · Dahlonega, GA
NPI 1083174973 · NPPES record last updated Oct 24, 2024
Key facts
- NPI
- 1083174973
- Entity type
- Organization (NPI type 2)
- Primary specialty
- General Acute Care Hospital 282N00000X
- Legal business name
- NGMC LUMPKIN, LLC
- Practice address
- 495 Highway 400
Dahlonega, GA 30533-6823 - Phone
- (770) 219-9000
- NPI assigned
- Mar 25, 2019
- Organization subpart
- No
Authorized official
- Name
- Mr. Brian D Steines
- Title
- VP of Finance
- Phone
- (770) 219-9000
Owners & managing parties with NPI records 3
-
Deepak K Aggarwal, M.D.
-
Mohak P Dave, M.D.
Practitioners 12
-
Jeh-Wei Cheng, MD
-
Laura Divoky, M.D.
-
Landai Nguyen, DO
-
Joshua Todd Mendelson, M.D.
-
Damodhar Nerella, MD
Affiliated clinicians 276
-
Raza Abbas, M.D.
-
Elia G Abboud, MD
-
Eihab Nail Abdelfatah, M.D.
-
Giancarlo Acosta, M.D.
-
Tejumade Adelore, M.D
-
Ismailu O Agbaje, PHD MD
-
Joon Ahn, MD
-
Olufemi Bunmi Aina, MBBS
-
Samer Othman Alharthi, M.D.
-
Sana Hussain Ansari, M.D.
-
Edem Koku Avoke, MD
-
Craig Joseph Baden, MD, MPH
-
David Ray Bailey Jr., M.D.
-
Preston Ball, MD
-
Lalitha Bandi, M.D.
-
Chad James Bell, PA
-
Alexander G Benz, MD
Medicare Care Compare: Hospital
- Listed as
- Northeast Georgia Medical Center Lumpkin
- Overall star rating
- ★★★★★ 5 of 5
- Type
- Acute Care Hospitals
- Ownership
- Voluntary non-profit - Other
- Medicare certification status
- Active
- Emergency services
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in GA
Hospital certification: CCN 110237
- Legal name
- NGMC LUMPKIN, LLC
- Certification status
- Active
- Provider type (POS)
- Hospital – Short-term
- Participating since
- Nov 15, 2019
- Last certification
- Sep 4, 2025
- Beds
- 52 (10 certified)
- Ownership / control type
- Other
- Organization structure
- LLC · Non-profit
- Incorporated
- Mar 17, 2018 in GA
- Enrollment address
- 495 Highway 400
Dahlonega, GA 30533-6823 - Hospital subgroups
- Acute care
All disclosed owners & managing parties 22
| Name | Role | Since | Share |
|---|---|---|---|
| Alexander a. Wayne |
Corporate Director |
Jul 1, 2019 | |
| Northeast Georgia Health System Inc |
5% Or Greater Direct Ownership Interest | Jul 1, 2019 | 100% |
| Brian D Steines |
Corporate Officer |
Jul 1, 2019 | |
| Corporate Director |
Jul 19, 2019 | ||
| W-2 Managing Employee |
Jul 1, 2019 | ||
| Cynthia Green |
Corporate Director |
Feb 1, 2025 | |
| Mohak Dave |
Corporate Director |
Jul 1, 2019 | |
| Glennis Barnes |
Corporate Director |
Feb 1, 2025 | |
| Phillippa Moss |
Corporate Director |
Feb 1, 2025 | |
| Deepak K Aggarwal |
Corporate Director |
Feb 1, 2025 | |
| Letrell Simpson |
Corporate Director |
Feb 1, 2025 | |
| Semuel Maysonet |
Corporate Director |
Feb 1, 2025 | |
| Greg Ours |
Corporate Director |
Feb 1, 2025 | |
| Brad Puryear |
Corporate Director |
Feb 1, 2025 | |
| William S Price |
Corporate Director |
Jul 1, 2019 | |
| Matthew L Hanley |
Corporate Officer |
Apr 1, 2025 | |
| Corporate Director |
Apr 1, 2025 | ||
| Mary L Coyle |
Corporate Director |
Jul 1, 2019 | |
| Kevin J Matson |
Corporate Director |
Feb 1, 2025 | |
| Richard K Whitehead |
Corporate Director |
Jul 1, 2019 | |
| Philip a Wilheit |
Corporate Director |
Jul 1, 2019 | |
| Jacquelyn L. Wallace |
Corporate Director |
Jul 1, 2019 | |
| Andrea D. Savage |
W-2 Managing Employee |
Sep 12, 2024 | |
| Pierpont F Brown |
Corporate Director |
Feb 1, 2025 | |
| John Kueven |
Corporate Director |
Feb 1, 2025 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20191218001869 | GA | Part a Provider - Hospital | 1759614019 | Practice locations: Dahlonega, GA |
| O20220831002130 | GA | Part B Supplier - Clinic/Group Practice | 1759614019 |
Receives reassigned benefits from 9 practitioners Practice locations: Dahlonega, GA |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Acute Care Hospital | 282N00000X | Yes |
Addresses
Primary practice location
495 Highway 400
Dahlonega, GA 30533-6823
Mailing address
PO Box 741891
Atlanta, GA 30374-1891
Phone (770) 219-5911
Other providers in Dahlonega, GA
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- Richard Niver
- North Georgia Counseling and Education Center
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- North Georgia Therapeutic Counseling
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All providers in Dahlonega, GA · General Acute Care Hospital in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 24, 2024. 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.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.