Ty Cobb Healthcare System

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

1-095-955 Issued in GA

Legal business name

TY COBB HEALTHCARE SYSTEM

Doing business as

Cobb Health Care Center

Practice address

2430 Paoli St
Comer, GA 30629-3470

Phone

(706) 783-5116

Fax

(706) 783-5117

NPI assigned

Aug 22, 2006

Last updated

Oct 3, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. John S Barber

Title

Cfo

Phone

(706) 245-1850

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Cobb Health Care Center Doing business as

Locations

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

{
    "created_epoch": "1156204800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1222992000000",
    "number": "1205942109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2430 PAOLI ST",
            "city": "COMER",
            "state": "GA",
            "postal_code": "306293470",
            "telephone_number": "706-783-5116",
            "fax_number": "706-783-5117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2430 PAOLI ST",
            "city": "COMER",
            "state": "GA",
            "postal_code": "306293470",
            "telephone_number": "706-783-5116",
            "fax_number": "706-783-5117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TY COBB HEALTHCARE SYSTEM",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-22",
        "last_updated": "2008-10-03",
        "status": "A",
        "authorized_official_last_name": "BARBER",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "706-245-1850",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "GA",
            "license": "1-095-955",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00220448A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cobb Health Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Skilled Nursing Facility in Comer, GA
• Providers in Comer, GA by specialty
• Skilled Nursing Facility in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 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.