NPIMap

Organization Active NPI

The Baxley and Appling County Hospital Authority

  • Psychiatric Hospital Unit
  • Baxley, GA
National Provider Identifier
1104828623
Registry record updated Jan 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric Hospital UnitTaxonomy code 273R00000X
License
273R00000X Issued in GA
Legal business name
THE BAXLEY AND APPLING COUNTY HOSPITAL AUTHORITY
Practice address
163 E Tollison St
Baxley, GA 31513-0120
Phone
(912) 367-9841
Fax
(912) 367-1272
NPI assigned
Aug 15, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2026

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

Authorized official

Name
Marie Barnes
Title
Credentialing Coordinator
Phone
(912) 367-9841

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric Hospital Unit 273R00000X 273R00000X GA Primary

Addresses

Primary practice location

163 E Tollison St
Baxley, GA 31513-0120

Mailing address

PO Box 2070
Baxley, GA 31515-2070
Phone (912) 367-9841

Other identifiers 1

IdentifierTypeStateIssuer
00000052AMedicaidGA

Other names 1

  • Appling Healthcare System Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080812000853 GA Part A Provider - Hospital 8426957325 Practice locations: Baxley, GA

Hospital certification: CCN 11S071

Legal name
THE BAXLEY AND APPLING COUNTY HOSPITAL AUTHORITY
Doing business as
APPLING HEALTHCARE SYSTEM
Organization structure
OtherNon-profit
Enrollment address
163 E. Tollison Street
Baxley, GA 31513-0120
Hospital Psychiatric Unit
Hospital subgroups
Psychiatric unit

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 7

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Appling Healthcare Syst18 organizations share this tax ID, including this one

Other organizations with this tax ID 17

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

View all 17

Ownership & related parties

All disclosed owners & managing parties 5

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Paul E Rentz Individual Corporate DirectorBoard Member Aug 26, 2013
Andrea Pierce Graham Individual Corporate DirectorCeo Jul 30, 2021 100%
W-2 Managing EmployeeCeo Jul 30, 2021 100%
Pam Dean Individual W-2 Managing Employee Jun 3, 1996
Cindy Tomberlin Individual Corporate OfficerChair of Board Jul 1, 2021 100%
Corporate DirectorChair of the Board Jul 1, 2021 100%
The Baxley and Appling County Hospital Authority Organization, Baxley, GA Operational/Managerial Control Nov 6, 2007

Owners & managing parties with NPI records 7

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

All facility ownership & control disclosures 6

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Appling Healthcare SystemBaxley, GA, CCN 110071 Hospital Operational/Managerial Control Nov 6, 2007
Appling Healthcare SystemBaxley, GA, CCN 11U071 Hospital Operational/Managerial Control Nov 6, 2007
Appling Nursing and Rehabilitation PavilionBaxley, GA, CCN 115262 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control		 Jan 1, 2000
Jan 1, 2000
Appling PediatricsBaxley, GA, CCN 118521 Rural health clinic 5% Or Greater Direct Ownership Interest Feb 18, 2009
Appling Medical GroupBaxley, GA, CCN 118520 Rural health clinic 5% Or Greater Direct Ownership Interest Feb 18, 2009
South Georgia Medical AssociatesBaxley, GA, CCN 118522 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Feb 18, 2009

Owned or controlled facilities with NPI records 6

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Facilities with the same owner 6

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1124064000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1768348800000",
    "number": "1104828623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2070",
            "city": "BAXLEY",
            "state": "GA",
            "postal_code": "315152070",
            "telephone_number": "912-367-9841",
            "fax_number": "912-367-1272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "163 E TOLLISON ST",
            "city": "BAXLEY",
            "state": "GA",
            "postal_code": "315130120",
            "telephone_number": "912-367-9841",
            "fax_number": "912-367-1272"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE BAXLEY AND APPLING COUNTY HOSPITAL AUTHORITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-15",
        "last_updated": "2026-01-14",
        "certification_date": "2026-01-14",
        "status": "A",
        "authorized_official_last_name": "BARNES",
        "authorized_official_first_name": "MARIE",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "912-367-9841"
    },
    "taxonomies": [
        {
            "code": "273R00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Unit",
            "state": "GA",
            "license": "273R00000X",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00000052A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Appling Healthcare System",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Appling Healthcare System",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Baxley, GA

Sources for this page

Verify at the official NPI Registry.