Burke Hospital Company
Organization Active NPI Multi-Specialty Clinic/Center · Springfield, GA
NPI 1104550342 · NPPES record last updated Oct 3, 2022
Key facts
- NPI
- 1104550342
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Multi-Specialty Clinic/Center 261QM1300X
- Legal business name
- BURKE HOSPITAL COMPANY
- Practice address
- 459 Hwy 119 S
Springfield, GA 31329-3021 - Phone
- (912) 542-0444
- Fax
- (833) 639-1102
- NPI assigned
- Jul 13, 2022
- Organization subpart
- No
Authorized official
- Name
- Michael S Hester
- Title
- Ceo
- Phone
- (912) 369-9400
Other NPIs on the same Medicare enrollment 13
Corporate family (same tax ID) 17
Practitioners 1
-
David M Doman, M.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20220411001540 | GA | Part B Supplier - Clinic/Group Practice | 3476956012 |
Receives reassigned benefits from 18 practitioners 13 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Springfield, GA; Waynesboro, GA; Thomson, GA; Swainsboro, GA; Statesboro, GA; Sandersville, GA; Millen, GA; Louisville, GA |
National Provider Directory
- Tax ID family
- Burke Hospital Company
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Multi-Specialty Clinic/Center | 261QM1300X | Yes |
Addresses
Primary practice location
459 Hwy 119 S
Springfield, GA 31329-3021
Mailing address
459 Hwy 119 S
Springfield, GA 31329-3021
Other names
- Southeastern Spine and Pain
Other providers in Springfield, GA
- B&B Care Services, Inc.
- B&B Care, Inc.
- Alice Benenhaley
- John Bennett
- Bloom Within Counseling
- Careplus Urgent Care, LLC
- Michael P Carter
- Chatham Orthopaedic Associates, PA
- Latronda Coble
- Stacie Colello
All providers in Springfield, GA · Multi-Specialty Clinic/Center 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 3, 2022. 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.