NPIMap

Organization Active NPI

Pathways Center for Behavioral and Developmental Growth

  • Community/Behavioral Health Agency
  • Barnesville, GA
National Provider Identifier
1124183082
Registry record updated Feb 26, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
PATHWAYS CENTER FOR BEHAVIORAL AND DEVELOPMENTAL GROWTH
Practice address
101 Commerce Plaza
Suite 3
Barnesville, GA 30204-1680
Phone
(770) 358-5269
Fax
(770) 872-3730
NPI assigned
Dec 22, 2006
Last updated
Feb 26, 2013By the provider in NPPES
Organization subpart
Yes
Parent organization
PATHWAYS CENTER FOR BEHAVIORAL AND DEVELOPMENTAL GROWTHAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 26, 2013

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

Authorized official

Name
Jade Russell Benefield, MBA
Title
Executive Director
Phone
(706) 845-4045

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

101 Commerce Plaza
Suite 3
Barnesville, GA 30204-1680

Mailing address

122 Gordon Commercial Drive
Suite C
Lagrange, GA 30240-5740
Phone (706) 845-4045

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040430000883 GA Part B Supplier - Clinic/Group Practice 5193712073 Receives reassigned benefits from 23 practitioners
9 other NPIs on this enrollment
Practice locations: Carrollton, GA; Franklin, GA; Greenville, GA; Griffin, GA; Lagrange, GA; Newnan, GA

Other NPIs on the same Medicare enrollment 9

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

National Provider Directory

National Provider Directory
Part of
Chatt Flint MH Mr Sa

Locations

101 Commerce Pl
Ste 3
Barnesville, GA 30204
Phone (770) 358-5269

527 Tanner St
Carrollton, GA 30117
Phone (678) 390-6575

244 Odell Rd
Ste 6
Griffin, GA 30224
Phone (770) 229-3407

104 Corporate Park East Ct
Lagrange, GA 30241
Phone (706) 845-4054

120 Gordon Commercial Dr
Ste B
Lagrange, GA 30240
Phone (706) 845-4054

124 Gordon Commercial Dr
Lagrange, GA 30240
Phone (678) 854-2150

12 Savannah St
Newnan, GA 30263
Phone (770) 254-7230

74 Hospital Rd
Newnan, GA 30263
Phone (678) 854-6090

8 Franklin Rd
Newnan, GA 30263
Phone (678) 423-4610

Practitioners & affiliated clinicians

Practitioners 33

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 33

NPI Registry JSON

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

{
    "created_epoch": "1166745600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1361836800000",
    "number": "1124183082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "122 GORDON COMMERCIAL DRIVE",
            "address_2": "SUITE C",
            "city": "LAGRANGE",
            "state": "GA",
            "postal_code": "302405740",
            "telephone_number": "706-845-4045",
            "fax_number": "706-845-4367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 COMMERCE PLAZA",
            "address_2": "SUITE 3",
            "city": "BARNESVILLE",
            "state": "GA",
            "postal_code": "302041680",
            "telephone_number": "770-358-5269",
            "fax_number": "770-872-3730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PATHWAYS CENTER FOR BEHAVIORAL AND DEVELOPMENTAL GROWTH",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PATHWAYS CENTER FOR BEHAVIORAL AND DEVELOPMENTAL GROWTH",
        "enumeration_date": "2006-12-22",
        "last_updated": "2013-02-26",
        "status": "A",
        "authorized_official_last_name": "BENEFIELD",
        "authorized_official_first_name": "JADE",
        "authorized_official_middle_name": "RUSSELL",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "706-845-4045",
        "authorized_official_credential": "MBA"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Barnesville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2013; 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.