College Park Regional Health Center

Key facts

NPI

1124174974

Entity type

Organization (NPI type 2)

Primary specialty

Public Health or Welfare Agency 251K00000X

Legal business name

COLLEGE PARK REGIONAL HEALTH CENTER

Practice address

1920 John Wesley Ave
College Park, GA 30337-3606

Phone

(404) 765-4155

Fax

(404) 765-4149

NPI assigned

Jan 26, 2007

Organization subpart

Yes

Parent organization (as reported)

FULTON COUNTY DEPT OF HEALTH&WELLNESS

Authorized official

Name

Dr. Kim Turner, D.O.

Title

Health Director

Phone

(404) 730-1202

National Provider Directory

Part of

Fulton County Government

Locations

Specialties & licenses

Addresses

Other identifiers

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jun 24, 2008.

{
    "created_epoch": "1169769600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214265600000",
    "number": "1124174974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "99 JESSE HILL JR. DRIVE",
            "address_2": "ROOM 402",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "30303",
            "telephone_number": "404-730-1217",
            "fax_number": "404-730-1233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1920 JOHN WESLEY AVE",
            "city": "COLLEGE PARK",
            "state": "GA",
            "postal_code": "303373606",
            "telephone_number": "404-765-4155",
            "fax_number": "404-765-4149"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLLEGE PARK REGIONAL HEALTH CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FULTON COUNTY DEPT OF HEALTH&WELLNESS",
        "enumeration_date": "2007-01-26",
        "last_updated": "2008-06-24",
        "status": "A",
        "authorized_official_last_name": "TURNER",
        "authorized_official_first_name": "KIM",
        "authorized_official_title_or_position": "HEALTH DIRECTOR",
        "authorized_official_telephone_number": "404-730-1202",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000051884G",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000698662D",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000457773G",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000457773S",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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All providers in College Park, GA · Public Health or Welfare Agency in Georgia