Glascock County Board of Health
Organization Active NPI Public Health or Welfare Agency · Gibson, GA
NPI 1083665285 · NPPES record last updated Mar 5, 2024
Key facts
- NPI
- 1083665285
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Public Health or Welfare Agency 251K00000X
- Legal business name
- GLASCOCK COUNTY BOARD OF HEALTH
- Practice address
- 658 W Main St
Gibson, GA 30810-4013 - Phone
- (706) 598-2061
- Fax
- (706) 598-2442
- NPI assigned
- May 12, 2006
- Organization subpart
- No
Authorized official
- Name
- Lee Ann Donohue, MD
- Title
- Districh Health Director
- Phone
- (706) 825-6914
Other NPIs with the same Medicare PAC ID 1
Corporate family (same tax ID) 1
Practitioners 6
-
Valerie A. Fraley, MSN, WHNP-BC
-
Morgan Hardigree, APRN
-
Rebecca Youngblood Kershner, WHNP-BC
-
Kathy E. Linebarger, FNP
-
Nona Joe Lord, RN, BSN
-
Shalonna Stewart, FNP-C
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20131021001704 | GA | Part B Supplier - Mass Immunization (Roster Biller Only) | 9436384898 | Practice locations: Gibson, GA |
National Provider Directory
- Tax ID family
- East Central Health District
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Public Health or Welfare Agency | 251K00000X | Yes |
Addresses
Primary practice location
658 W Main St
Gibson, GA 30810-4013
Mailing address
1916 N Leg Rd
Augusta, GA 30909-4402
Phone (706) 667-4265
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000456552H | Medicaid | GA | |
| 000573361A | Medicaid | GA | |
| P00094913 | Other | GA | RAILROAD MEDICARE |
| 000051851E | Medicaid | GA | |
| 000676563D | Medicaid | GA |
Other names
- GLASCOCK COUNTY HEALTH DEARTMENT
Other providers in Gibson, GA
- Cornelia Benoit
- Community Health Care Systems, Inc.
- Doriann Dye
- Gibson Health Opco LLC
- Glascock County Board of Health
- Glascock County Boe
- Glascock County Health Care LLC
- Glascock County Health Care LLC
- Nona Joe Lord
- Holly Lynn Stewart
All providers in Gibson, GA · Public Health or Welfare Agency in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 5, 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.