NPIMap

Organization Active NPI

Polk County Board of Health

  • Public Health or Welfare Agency
  • Cedartown, GA
National Provider Identifier
1093944423
Registry record updated Jul 7, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Public Health or Welfare AgencyTaxonomy code 251K00000X
License
025271 Issued in GA
Legal business name
POLK COUNTY BOARD OF HEALTH
Doing business as
Polk Primary Care Clinic
Practice address
508 N Main St
Cedartown, GA 30125-2302
Phone
(706) 749-2270
Fax
(706) 749-2298
NPI assigned
Jul 7, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2009

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

Authorized official

Name
Dr. Christopher Wade Sellers, M.D.
Title
Medical Director
Phone
(706) 295-6704

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Public Health or Welfare Agency 251K00000X 025271 GA Primary

Addresses

Primary practice location

508 N Main St
Cedartown, GA 30125-2302

Mailing address

508 N Main St
Cedartown, GA 30125-2302
Phone (706) 749-2270

Other names 1

  • Polk Primary Care Clinic Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Polk County Board of Health3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Locations

508 N Main St
Cedartown, GA 30125
Phone (706) 749-2270

NPI Registry JSON

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

{
    "created_epoch": "1246924800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1246924800000",
    "number": "1093944423",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "508 N MAIN ST",
            "city": "CEDARTOWN",
            "state": "GA",
            "postal_code": "301252302",
            "telephone_number": "706-749-2270",
            "fax_number": "706-749-2298"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "508 N MAIN ST",
            "city": "CEDARTOWN",
            "state": "GA",
            "postal_code": "301252302",
            "telephone_number": "706-749-2270",
            "fax_number": "706-749-2298"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POLK COUNTY BOARD OF HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-07-07",
        "last_updated": "2009-07-07",
        "status": "A",
        "authorized_official_last_name": "SELLERS",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "WADE",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "706-295-6704",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": "GA",
            "license": "025271",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Polk Primary Care Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Cedartown, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.