NPIMap

Organization Active NPI

Nes Georgia, Inc.

  • Emergency Medicine Physician
  • Hazlehurst, GA
National Provider Identifier
1144201559
Registry record updated Apr 29, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 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
Last updated
Apr 29, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2013

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

Authorized official

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X Primary

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 2

IdentifierTypeStateIssuer
300017172IMedicaidGA
CC4853OtherRR MEDICARE

Medicare participation

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

Enrollment records 1

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

Other NPIs with the same Medicare PAC ID 1

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
Nes Georgia Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Practitioners & affiliated clinicians

Practitioners 66

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 66

NPI Registry JSON

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

{
    "created_epoch": "1131667200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1367193600000",
    "number": "1144201559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 277329",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303847329",
            "telephone_number": "800-377-8721",
            "fax_number": "304-697-1155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "163 S TALLAHASSEE ST",
            "city": "HAZLEHURST",
            "state": "GA",
            "postal_code": "315396465",
            "telephone_number": "912-375-7781",
            "fax_number": "912-375-4055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NES GEORGIA, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-11",
        "last_updated": "2013-04-29",
        "status": "A",
        "authorized_official_last_name": "MOORE",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "415-435-4591"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300017172I",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "CC4853",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hazlehurst, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 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.