Organization Active NPI

Health First

Doing business as Mountain Valley Medical Center

  • Rural Health Clinic/Center
  • Dillard, GA
National Provider Identifier
1134316219
Registry record updated Feb 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
HEALTH FIRST
Doing business as
Mountain Valley Medical Center
Practice address
92 Bettys Creek Rd
Dillard, GA 30537-2257
Phone
(706) 746-6571
Fax
(706) 746-5643
NPI assigned
Oct 2, 2007
Last updated
Feb 24, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2025

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

Authorized official

Name
Carlie Suzanne Pennington
Title
Office Manager
Phone
(706) 746-6571

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X NU Primary
Family Medicine Physician 207Q00000X 025380 GA

Addresses

Primary practice location

92 Bettys Creek Rd
Dillard, GA 30537-2257

Mailing address

PO Box 444
Dillard, GA 30537-0444
Phone (706) 746-6571

Other identifiers 2

IdentifierTypeStateIssuer
000273831GMedicaidGA
1669589594OtherGANPI

Other names 1

  • MOUNTAIN VALLEY MEDICAL CENTER Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080710000363 GA Part B Supplier - Clinic/Group Practice 7416035977 Receives reassigned benefits from 1 practitioner
Practice locations: Dillard, GA

National Provider Directory

National Provider Directory

Interoperability endpoints

  • FHIR API: https://epicproxy.et1426.epichosted.com/FHIRProxyPRD/api/FHIR/R4

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1191283200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1740355200000",
    "number": "1134316219",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 444",
            "city": "DILLARD",
            "state": "GA",
            "postal_code": "305370444",
            "telephone_number": "706-746-6571",
            "fax_number": "706-746-5643"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "92 BETTYS CREEK RD",
            "city": "DILLARD",
            "state": "GA",
            "postal_code": "305372257",
            "telephone_number": "706-746-6571",
            "fax_number": "706-746-5643"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTH FIRST",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-02",
        "last_updated": "2025-02-24",
        "certification_date": "2025-02-24",
        "status": "A",
        "authorized_official_last_name": "PENNINGTON",
        "authorized_official_first_name": "CARLIE",
        "authorized_official_middle_name": "SUZANNE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "706-746-6571"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "025380",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000273831G",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1669589594",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MOUNTAIN VALLEY MEDICAL CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Dillard, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2025; 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.