Active NPI
Choices for Life of Georgia, LLC
- Community/Behavioral Health Agency
- Columbus, GA
National Provider Identifier
1164668596
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Behavioral Health Agency
- License
- CPFC001072
- Legal business name
- CHOICES FOR LIFE OF GEORGIA, LLC
- Practice address
- 4330 Gilbert Ave
Columbus, GA 31904-6519 - Phone
- (770) 338-0800
- Fax
- (770) 338-2219
- NPI assigned
- Jan 7, 2009
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Douglas Charles Fellrath, JD
- Title
- Ceo
- Phone
- (405) 751-0800
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Behavioral Health Agency | 251S00000X | CPFC001072 | GA | Primary |
Addresses
Primary practice location
4330 Gilbert Ave
Columbus, GA 31904-6519
Mailing address
4330 Gilbert Ave
Columbus, GA 31904-6519
Phone (770) 338-0800
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 001462443A | Medicaid | GA |
National Provider Directory
National Provider Directory- Tax ID family
- Choices for Life of Georgia LLC
Other organizations with this tax ID 2
Organizations that report the same tax identification number in the National Provider Directory.
-
- Community/Behavioral Health Agency
- Lawrenceville, GA
- NPI 1437395860
-
- Community/Behavioral Health Agency
- Valdosta, GA
- NPI 1841328960
Locations
4330 Gilbert Ave
Columbus, GA 31904
Phone (770) 338-0800
Interoperability endpoints
- https://api.qualifacts.org/api/fhir/cflfostercare/r4/
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1231286400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1231286400000",
"number": "1164668596",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4330 GILBERT AVE",
"city": "COLUMBUS",
"state": "GA",
"postal_code": "319046519",
"telephone_number": "770-338-0800",
"fax_number": "770-338-2219"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4330 GILBERT AVE",
"city": "COLUMBUS",
"state": "GA",
"postal_code": "319046519",
"telephone_number": "770-338-0800",
"fax_number": "770-338-2219"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "CHOICES FOR LIFE OF GEORGIA, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2009-01-07",
"last_updated": "2009-01-07",
"status": "A",
"authorized_official_last_name": "FELLRATH",
"authorized_official_first_name": "DOUGLAS",
"authorized_official_middle_name": "CHARLES",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "405-751-0800",
"authorized_official_name_prefix": "Mr.",
"authorized_official_credential": "JD"
},
"taxonomies": [
{
"code": "251S00000X",
"taxonomy_group": "",
"desc": "Community/Behavioral Health",
"state": "GA",
"license": "CPFC001072",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "001462443A",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Columbus, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.