NPIMap

Organization Active NPI

Community Service Board of Middle Georgia

  • Community/Behavioral Health Agency
  • Dublin, GA
National Provider Identifier
1104255256
Registry record updated Nov 8, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
084851 Issued in GA
Legal business name
COMMUNITY SERVICE BOARD OF MIDDLE GEORGIA
Practice address
2121A Bellevue Rd
Dublin, GA 31021-2998
Phone
(478) 272-1190
Fax
(478) 275-6649
NPI assigned
Nov 8, 2013
Last updated
Nov 8, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2013

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

Authorized official

Name
Cynthia Reid
Title
Operations Analyst
Phone
(478) 272-1190

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X 084851 GA Primary

Addresses

Primary practice location

2121A Bellevue Rd
Dublin, GA 31021-2998

Mailing address

2121A Bellevue Rd
Dublin, GA 31021-2998
Phone (478) 272-1190

Other identifiers 2

IdentifierTypeStateIssuer
300030912AMedicaidGA
1689657637MedicaidGA

Other names 1

  • CSB OF MIDDLE GEORGIA Other name

National Provider Directory

National Provider Directory
Tax ID family
Community Service Board of Middle Georgia30 organizations share this tax ID, including this one

Other organizations with this tax ID 29

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

View all 29

Locations

2121A Bellevue Rd
Dublin, GA 31021
Phone (478) 272-1190

Practitioners & affiliated clinicians

Practitioners 1

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": "1383868800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1383868800000",
    "number": "1104255256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2121A BELLEVUE RD",
            "city": "DUBLIN",
            "state": "GA",
            "postal_code": "310212998",
            "telephone_number": "478-272-1190",
            "fax_number": "478-275-6649"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2121A BELLEVUE RD",
            "city": "DUBLIN",
            "state": "GA",
            "postal_code": "310212998",
            "telephone_number": "478-272-1190",
            "fax_number": "478-275-6649"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY SERVICE BOARD OF MIDDLE GEORGIA",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-11-08",
        "last_updated": "2013-11-08",
        "status": "A",
        "authorized_official_last_name": "REID",
        "authorized_official_first_name": "CYNTHIA",
        "authorized_official_title_or_position": "OPERATIONS ANALYST",
        "authorized_official_telephone_number": "478-272-1190"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "GA",
            "license": "084851",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300030912A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1689657637",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CSB OF MIDDLE GEORGIA",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Dublin, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2013; 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.