Nes Georgia, Inc.

Organization Active NPI Emergency Medicine Physician · Hazlehurst, GA

NPI 1144201559 · NPPES record last updated Apr 29, 2013

Key facts

NPI
1144201559
Entity type
Organization (NPI type 2)
Primary specialty
Emergency Medicine Physician 207P00000X
Legal business name
NES GEORGIA, INC.
Practice address
163 S Tallahassee St
Hazlehurst, GA 31539-6465
Phone
(912) 375-7781
Fax
(912) 375-4055
NPI assigned
Nov 11, 2005
Organization subpart
No

Authorized official

Name
Jennifer Moore
Title
Cfo
Phone
(415) 435-4591

Other NPIs on the same Medicare enrollment 1

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

Other NPIs with the same Medicare PAC ID 1

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

Corporate family (same tax ID) 1

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

Practitioners 66

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 66

Medicare participation

Medicare fee-for-service enrollment
Enrolled in GA

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20040729000602 GA Part B Supplier - Clinic/Group Practice 0345210001 Receives reassigned benefits from 17 practitioners
1 other NPI on this enrollment
Practice locations: Hazlehurst, GA; Waynesboro, GA

National Provider Directory

Tax ID family
Nes Georgia Inc (2 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician
Group: 193200000X MULTI-SPECIALTY GROUP
207P00000X Yes

Addresses

Primary practice location

163 S Tallahassee St
Hazlehurst, GA 31539-6465

Mailing address

PO Box 277329
Atlanta, GA 30384-7329
Phone (800) 377-8721

Other identifiers

IdentifierTypeStateIssuer
300017172IMedicaidGA
CC4853OtherRR MEDICARE

Other providers in Hazlehurst, GA

All providers in Hazlehurst, GA · Emergency Medicine Physician in Georgia

Sources for this page

Verify at the official NPI Registry.