NPIMap

Organization Active NPI

Middle Flint Area Community Service Board

Doing business as Warner Robins Outpatient

  • Community/Behavioral Health Agency
  • Warner Robins, GA
National Provider Identifier
1215934773
Registry record updated Dec 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
582105225 Issued in GA
Legal business name
MIDDLE FLINT AREA COMMUNITY SERVICE BOARD
Doing business as
Warner Robins Outpatient
Practice address
940 Ga Highway 96 Ste a
Warner Robins, GA 31088-2587
Phone
(478) 988-1002
Fax
(478) 988-8780
NPI assigned
Jun 30, 2005
Last updated
Dec 15, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
MIDDLE FLINT AREA COMMUNITY SERVICE BOARDAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 15, 2023

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

Authorized official

Name
Margaret Jordan
Title
RCM Manager
Phone
(229) 815-5454

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X 582105225 GA Primary

Addresses

Primary practice location

940 Ga Highway 96 Ste a
Warner Robins, GA 31088-2587

Mailing address

940 Ga Highway 96 Ste a
Warner Robins, GA 31088-2587
Phone (478) 988-1002

Other practice location 1

108 Mimosa Dr
Fort Valley, GA 31030-3717
Phone (478) 825-9045

Other practice location 2

940 Ga Highway 96
Warner Robins, GA 31088-2584
Phone (478) 988-1222 ext. 246

Other practice location 3

200 Northspring Ct
Warner Robins, GA 31093-1660
Phone (478) 923-1065

Other practice location 4

108 Vassas Ct
Warner Robins, GA 31088-3740
Phone (478) 988-0018

Other identifiers 7

IdentifierTypeStateIssuer
000604502AJMedicaidGA
000604502AIMedicaidGA
000604502AGMedicaidGA
000604502PMedicaidGA
000604502AMedicaidGA
000450128GMedicaidGA
000604502APMedicaidGA

Other names 1

  • Warner Robins Outpatient Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040204000828 GA Part B Supplier - Clinic/Group Practice 3274426150 Receives reassigned benefits from 29 practitioners
6 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Americus, GA; Cordele, GA; Fort Valley, GA; Warner Robins, GA
O20040601000201 GA Part B Supplier - Clinic/Group Practice 8921089350 Receives reassigned benefits from 1 practitioner
3 other NPIs on this enrollment
Practice locations: Warner Robins, GA; Fort Valley, GA

Other NPIs on the same Medicare enrollment 6

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

National Provider Directory

National Provider Directory
Tax ID family
Middle Flint Behavior H24 organizations share this tax ID, including this one
Part of
Middle Flint Behavior H

Other organizations with this tax ID 23

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

View all 23

Locations

108 Mimosa Dr
Fort Valley, GA 31030
Phone (478) 825-9045

940 GA Highway 96
Warner Robins, GA 31088
Phone (478) 988-1002

940 GA Highway 96
Ste C
Warner Robins, GA 31088
Phone (478) 988-7100

Practitioners & affiliated clinicians

Practitioners 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1120089600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1702598400000",
    "number": "1215934773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "940 GA HIGHWAY 96 STE A",
            "city": "WARNER ROBINS",
            "state": "GA",
            "postal_code": "310882587",
            "telephone_number": "478-988-1002",
            "fax_number": "478-988-8780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "940 GA HIGHWAY 96 STE A",
            "city": "WARNER ROBINS",
            "state": "GA",
            "postal_code": "310882587",
            "telephone_number": "478-988-1002",
            "fax_number": "478-988-8780"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "108 Mimosa Dr",
            "address_purpose": "LOCATION",
            "city": "Fort Valley",
            "state": "GA",
            "postal_code": "310303717",
            "country_code": "US",
            "telephone_number": "478-825-9045",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "940 Ga Highway 96",
            "address_purpose": "LOCATION",
            "city": "Warner Robins",
            "state": "GA",
            "postal_code": "310882584",
            "country_code": "US",
            "telephone_number": "478-988-1222 x246",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "200 Northspring Ct",
            "address_purpose": "LOCATION",
            "city": "Warner Robins",
            "state": "GA",
            "postal_code": "310931660",
            "country_code": "US",
            "telephone_number": "478-923-1065",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "108 Vassas Ct",
            "address_purpose": "LOCATION",
            "city": "Warner Robins",
            "state": "GA",
            "postal_code": "310883740",
            "country_code": "US",
            "telephone_number": "478-988-0018",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MIDDLE FLINT AREA COMMUNITY SERVICE BOARD",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MIDDLE FLINT AREA COMMUNITY SERVICE BOARD",
        "enumeration_date": "2005-06-30",
        "last_updated": "2023-12-15",
        "certification_date": "2023-12-15",
        "status": "A",
        "authorized_official_last_name": "JORDAN",
        "authorized_official_first_name": "MARGARET",
        "authorized_official_title_or_position": "RCM MANAGER",
        "authorized_official_telephone_number": "229-815-5454"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "GA",
            "license": "582105225",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000604502AJ",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000604502AI",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000604502AG",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000604502P",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000604502A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000450128G",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000604502AP",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Warner Robins Outpatient",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Warner Robins, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2023; 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.