NPIMap

Organization Active NPI

South Georgia CSB

Doing business as Brooks DD Services

  • Developmental Disabilities Clinic/Center
  • Quitman, GA
National Provider Identifier
1154494359
Registry record updated Dec 15, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmental Disabilities Clinic/CenterTaxonomy code 261QD1600X
Legal business name
SOUTH GEORGIA CSB
Doing business as
Brooks DD Services
Practice address
1200 Roundtree St
Quitman, GA 31643-3712
Phone
(229) 263-7510
Fax
(229) 263-4925
NPI assigned
Nov 16, 2006
Last updated
Dec 15, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2008

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

Authorized official

Name
Mrs. Sue Gupton
Title
Chief Executive Officer
Phone
(229) 671-6101

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Developmental Disabilities Clinic/Center 261QD1600X Primary

Addresses

Primary practice location

1200 Roundtree St
Quitman, GA 31643-3712

Mailing address

1200 Roundtree St
Quitman, GA 31643-3712
Phone (229) 263-7510

Other names 1

  • Brooks DD Services Doing business as

National Provider Directory

National Provider Directory
Tax ID family
South Georgia Service B29 organizations share this tax ID, including this one

Other organizations with this tax ID 28

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

View all 28

Locations

1200 Roundtree St
Quitman, GA 31643
Phone (229) 263-7510

NPI Registry JSON

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

{
    "created_epoch": "1163635200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1229299200000",
    "number": "1154494359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 ROUNDTREE ST",
            "city": "QUITMAN",
            "state": "GA",
            "postal_code": "316433712",
            "telephone_number": "229-263-7510",
            "fax_number": "229-263-4925"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 ROUNDTREE ST",
            "city": "QUITMAN",
            "state": "GA",
            "postal_code": "316433712",
            "telephone_number": "229-263-7510",
            "fax_number": "229-263-4925"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH GEORGIA CSB",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-16",
        "last_updated": "2008-12-15",
        "status": "A",
        "authorized_official_last_name": "GUPTON",
        "authorized_official_first_name": "SUE",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "229-671-6101",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QD1600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Brooks DD Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Quitman, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.