NPIMap

Organization Active NPI

Palmetto Health Council Inc

  • Federally Qualified Health Center (FQHC)
  • Zebulon, GA
National Provider Identifier
1134344732
Registry record updated May 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
License
H800040 Issued in GA
Legal business name
PALMETTO HEALTH COUNCIL INC
Practice address
16201 Barnesville St
Zebulon, GA 30295-3380
Phone
(770) 567-3323
Fax
(770) 567-0332
NPI assigned
Apr 17, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 14, 2025

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

Authorized official

Name
Tara L Brown, DMD
Title
Ceo
Phone
(404) 929-8824

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X H800040 GA
Federally Qualified Health Center (FQHC) 261QF0400X H800040 GA Primary

Addresses

Primary practice location

16201 Barnesville St
Zebulon, GA 30295-3380

Mailing address

643 Main St
Palmetto, GA 30268-1138
Phone (404) 929-8824

Other identifiers 1

IdentifierTypeStateIssuer
000228379AMedicaidGA

Other names 2

  • Community Medical Center Doing business as
  • YourTown Health Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050916000963 GA Part A Provider - Federally Qualified Health Center (FQHC) 3476586629 1 other NPI on this enrollment
Practice locations: Zebulon, GA

Federally qualified health center certification: CCN 111818

Legal name
PALMETTO HEALTH COUNCIL INC
Doing business as
YOURTOWN HEALTH
Certification status
Terminated Voluntary: merger or closure, Jun 1, 1996
Provider type (POS)
Federally qualified health center
Participating since
Oct 1, 1991
Last certification
Oct 1, 1991
Ownership / control type
For profit – partnership
Organization structure
CorporationNon-profit
Incorporated
Jun 1, 1978 in GA
Enrollment address
16201 Barnesville St
Zebulon, GA 30295-3380

Other NPIs with the same Medicare PAC ID 6

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 1

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

National Provider Directory

National Provider Directory
Tax ID family
Palmetto Health Council Inc6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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

Ownership & related parties

All disclosed owners & managing parties 10

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Thomas Morrow Individual Corporate Director Jun 27, 2007
Tara L Brown Individual Corporate OfficerCeo Dec 20, 2020
W-2 Managing Employee Dec 20, 2020
William Geeslin Individual Corporate Director Aug 30, 2022
Loretta M North Individual Corporate DirectorDirector Oct 1, 2011
Valerie Sutton Individual Corporate Director Aug 31, 2022
Patsy S Page Individual Corporate DirectorDirector Oct 1, 2010
David Haire Individual Corporate Director Mar 22, 2022
Pat Ackey Individual Corporate Director Oct 14, 2017
Calvin C Ruffin Individual Corporate DirectorDirector Oct 1, 2011
Carlos Montano Individual Corporate Director Jul 31, 2018

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Community Medical CenterWarm Springs, GA, CCN 111923 Federally qualified health center Operational/Managerial Control Nov 29, 2004

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners 6

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": "1176768000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1747180800000",
    "number": "1134344732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "643 MAIN ST",
            "city": "PALMETTO",
            "state": "GA",
            "postal_code": "302681138",
            "telephone_number": "404-929-8824",
            "fax_number": "404-929-9769"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16201 BARNESVILLE ST",
            "city": "ZEBULON",
            "state": "GA",
            "postal_code": "302953380",
            "telephone_number": "770-567-3323",
            "fax_number": "770-567-0332"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PALMETTO HEALTH COUNCIL INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-17",
        "last_updated": "2025-05-14",
        "certification_date": "2025-05-14",
        "status": "A",
        "authorized_official_last_name": "BROWN",
        "authorized_official_first_name": "TARA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "404-929-8824",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "H800040",
            "primary": false
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "GA",
            "license": "H800040",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000228379A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Community Medical Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "YourTown Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Zebulon, GA

Sources for this page

Verify at the official NPI Registry.