Organization Active NPI

Banks County Health Department

  • Public Health or Welfare Agency
  • Homer, GA
National Provider Identifier
1124112339
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Public Health or Welfare AgencyTaxonomy code 251K00000X
License
015524 Issued in GA
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

Updated by the provider on Aug 22, 2020

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)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
10044114OtherGAAMERIGROUP PROVIDER NUMBE
9179947OtherGADORAL PROVIDER NUMBER
00051972BMedicaidGA
00479751EMedicaidGA
00442945BMedicaidGA
39253OtherGAAVESIS PROVIDER NUMBER
00058638AMedicaidGA
00456442NMedicaidGA
338783OtherGAWELLCARE PROVIDER NUMBER

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
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 Department2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

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.

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.

Verify at the official NPI Registry.