Active NPI
Banks County Health Department
- Public Health or Welfare Agency
- Homer, GA
National Provider Identifier
1124112339
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Public Health or Welfare Agency
- License
- 015524
- Legal business name
- BANKS COUNTY HEALTH DEPARTMENT
- Practice address
- 667 Thompson Street
Homer, GA 30547 - Phone
- (706) 677-2296
- Fax
- (706) 677-4042
- NPI assigned
- Oct 3, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- David N Westfall, M.D.
- Title
- Public Health Director
- Phone
- (706) 677-2296
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Public Health or Welfare Agency | 251K00000X | 015524 | GA | Primary |
Addresses
Primary practice location
667 Thompson Street
Homer, GA 30547
Mailing address
667 Thompson St
Homer, GA 30547-3110
Phone (706) 677-2296
Other identifiers 9
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 10044114 | Other | GA | AMERIGROUP PROVIDER NUMBE |
| 9179947 | Other | GA | DORAL PROVIDER NUMBER |
| 00051972B | Medicaid | GA | |
| 00479751E | Medicaid | GA | |
| 00442945B | Medicaid | GA | |
| 39253 | Other | GA | AVESIS PROVIDER NUMBER |
| 00058638A | Medicaid | GA | |
| 00456442N | Medicaid | GA | |
| 338783 | Other | GA | WELLCARE PROVIDER NUMBER |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20120209000159 | GA | Part B Supplier - Public Health/Welfare Agency | 2365609922 | Practice locations: Homer, GA |
National Provider Directory
National Provider Directory- Tax ID family
- Banks County Health Department
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Public Health or Welfare Agency
- Homer, GA
- NPI 1962461178
Locations
667 Thompson St
Homer, GA 30547
Phone (706) 671-2296
Practitioners & affiliated clinicians
Practitioners 5
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Student in an Organized Health Care Education/Training Program
- Milledgeville, GA
- NPI 1871357855
-
- Registered Nurse
- Homer, GA
- NPI 1306932264
-
- Registered Nurse
- Homer, GA
- NPI 1902993611
-
- Dentist
- Homer, GA
- NPI 1144215765
-
- Registered Nurse
- Homer, GA
- NPI 1215330543
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159833600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1124112339",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "667 THOMPSON ST",
"city": "HOMER",
"state": "GA",
"postal_code": "305473110",
"telephone_number": "706-677-2296",
"fax_number": "706-677-4042"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "667 THOMPSON STREET",
"city": "HOMER",
"state": "GA",
"postal_code": "30547",
"telephone_number": "706-677-2296",
"fax_number": "706-677-4042"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "BANKS COUNTY HEALTH DEPARTMENT",
"organizational_subpart": "NO",
"enumeration_date": "2006-10-03",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "WESTFALL",
"authorized_official_first_name": "DAVID",
"authorized_official_middle_name": "N",
"authorized_official_title_or_position": "PUBLIC HEALTH DIRECTOR",
"authorized_official_telephone_number": "706-677-2296",
"authorized_official_credential": "M.D."
},
"taxonomies": [
{
"code": "251K00000X",
"taxonomy_group": "",
"desc": "Public Health or Welfare",
"state": "GA",
"license": "015524",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AMERIGROUP PROVIDER NUMBE",
"identifier": "10044114",
"state": "GA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DORAL PROVIDER NUMBER",
"identifier": "9179947",
"state": "GA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00051972B",
"state": "GA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00479751E",
"state": "GA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00442945B",
"state": "GA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AVESIS PROVIDER NUMBER",
"identifier": "39253",
"state": "GA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00058638A",
"state": "GA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00456442N",
"state": "GA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WELLCARE PROVIDER NUMBER",
"identifier": "338783",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Homer, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.