NPIMap

Organization Active NPI

George County Hospital

Doing business as Foot & Ankle Specialist

  • Foot & Ankle Surgery Podiatrist
  • Lucedale, MS
National Provider Identifier
1114664885
Registry record updated May 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
Legal business name
GEORGE COUNTY HOSPITAL
Doing business as
Foot & Ankle Specialist
Practice address
872 Winter St
Lucedale, MS 39452-5797
Phone
(601) 947-3161
NPI assigned
May 16, 2022
Last updated
May 16, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
GEORGE COUNTY HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 16, 2022

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

Authorized official

Name
Kara Joanne Goff
Title
Director
Phone
(601) 766-4212

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X Primary

Addresses

Primary practice location

872 Winter St
Lucedale, MS 39452-5797

Mailing address

PO Box 607
Lucedale, MS 39452-0607

Other names 1

  • Foot & Ankle Specialist Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040604000732 MS Part B Supplier - Clinic/Group Practice 5294717013 Receives reassigned benefits from 16 practitioners
4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Lucedale, MS

Other NPIs on the same Medicare enrollment 4

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
George Countymobile Inf10 organizations share this tax ID, including this one
Part of
George Countymobile Inf

Other organizations with this tax ID 9

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

Locations

838 Mill St
Ste A
Lucedale, MS 39452
Phone (601) 947-9190

Practitioners & affiliated clinicians

Practitioners 16

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.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1652659200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1652659200000",
    "number": "1114664885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 607",
            "city": "LUCEDALE",
            "state": "MS",
            "postal_code": "394520607"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "872 WINTER ST",
            "city": "LUCEDALE",
            "state": "MS",
            "postal_code": "394525797",
            "telephone_number": "601-947-3161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GEORGE COUNTY HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GEORGE COUNTY HOSPITAL",
        "enumeration_date": "2022-05-16",
        "last_updated": "2022-05-16",
        "certification_date": "2022-05-16",
        "status": "A",
        "authorized_official_last_name": "GOFF",
        "authorized_official_first_name": "KARA",
        "authorized_official_middle_name": "JOANNE",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "601-766-4212"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Foot & Ankle Specialist",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lucedale, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.