Clayton County Health District

Primary specialty

Public Health or Welfare AgencyTaxonomy code 251K00000X

Legal business name

CLAYTON COUNTY HEALTH DISTRICT

Practice address

1117 Battlecreek Rd
Jonesboro, GA 30236-2407

Phone

(678) 610-7199

Fax

(770) 603-4872

NPI assigned

Oct 4, 2006

Organization subpart

No

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

Authorized official

Name

Lacrecia Wortham

Title

Billing Specialist

Phone

(678) 610-7199

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 2

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

• Jacqueline Denise Ross, CRNP

  • Primary Care Nurse Practitioner
  • Fayetteville, GA
  • NPI 1578118048
  Medicare reassignment NPD
• Mario L Majette, MD

  • Family Medicine Physician
  • Silver Spring, MD
  • NPI 1356409338

  GA

  Medicare reassignment NPD

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1687996800000",
    "number": "1104911924",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1117 BATTLECREEK RD",
            "city": "JONESBORO",
            "state": "GA",
            "postal_code": "302362407",
            "telephone_number": "678-610-7199",
            "fax_number": "770-603-4872"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1117 BATTLECREEK RD",
            "city": "JONESBORO",
            "state": "GA",
            "postal_code": "302362407",
            "telephone_number": "678-610-7199",
            "fax_number": "770-603-4872"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLAYTON COUNTY HEALTH DISTRICT",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-04",
        "last_updated": "2023-06-29",
        "certification_date": "2023-06-29",
        "status": "A",
        "authorized_official_last_name": "WORTHAM",
        "authorized_official_first_name": "LACRECIA",
        "authorized_official_title_or_position": "BILLING SPECIALIST",
        "authorized_official_telephone_number": "678-610-7199"
    },
    "taxonomies": [
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000051928A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000058528A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000442934A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000456409B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Clayton Community Mental Health Substance Ab
• Clayton Community Mental Health Substance Ab
• Clayton Community Mental Health Substance Abuse Deve SVCS Board
• Clayton Community Service Board
• Clayton County Board of Commissioners
• Clayton County Public Schools Dba Worktec
• Clayton Healthcare, P.C.
• Clayton Medical Surgical
• Clayton Mhddad
• Clayton Mhddad

• Public Health or Welfare Agency in Jonesboro, GA
• Providers in Jonesboro, GA by specialty
• Public Health or Welfare Agency in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.