NPIMap

Organization Active NPI

Bacon County Health Services, Inc.

  • Medicare Defined Swing Bed Hospital Unit
  • Alma, GA
National Provider Identifier
1245446699
Registry record updated Mar 12, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medicare Defined Swing Bed Hospital UnitTaxonomy code 275N00000X
License
003-010 Issued in GA
Legal business name
BACON COUNTY HEALTH SERVICES, INC.
Practice address
302 S Wayne St
Alma, GA 31510-2922
Phone
(912) 632-8961
Fax
(912) 632-5000
NPI assigned
May 15, 2007
Last updated
Mar 12, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2008

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

Authorized official

Name
Mrs. Cindy Turner
Title
Chief Executive Officer
Phone
(912) 632-8961

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medicare Defined Swing Bed Hospital Unit 275N00000X 003-010 GA Primary

Addresses

Primary practice location

302 S Wayne St
Alma, GA 31510-2922

Mailing address

302 S Wayne St
P O Drawer 1987
Alma, GA 31510-2922
Phone (912) 632-8961

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080313000390 GA Part A Provider - Critical Access Hospital 1850294034 Practice locations: Alma, GA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1245446699. Details of each certification follow.

Hospital certification: CCN 11Z327

Legal name
BACON COUNTY HEALTH SERVICES, INC.
Organization structure
CorporationNon-profit
Incorporated
Jun 15, 1995 in GA
Enrollment address
302 S Wayne Street
Alma, GA 31510
Other Hospital Practice Location

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 4

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Family Medical Center5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

Ownership & related parties

All disclosed owners & managing parties 9

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Roger Staten Individual Corporate DirectorBoard Member Nov 26, 2007
Cindy Turner Individual Corporate OfficerCeo Sep 1, 2005
W-2 Managing EmployeeCeo Nov 26, 2007
Operational/Managerial ControlCeo Nov 26, 2007
Palmer Jordan Individual Corporate DirectorBoard Member Nov 26, 2007
Albert Wildes Individual Corporate DirectorBoard Member Jul 1, 2011
Cheryl C Dubose Individual Corporate OfficerChief Operating Officer Sep 13, 2006
Corporate Director Sep 13, 2016
W-2 Managing EmployeeCfo Sep 13, 2016
Daniel Johnson Individual Corporate DirectorBoard Member Jun 17, 2022
Charlene Bennett Individual Corporate DirectorBoard Member Nov 26, 2007
Robert Stanaland Individual Corporate DirectorBoard Member Nov 26, 2007
Belinda Medders Individual W-2 Managing EmployeePhysician Credentialing Coordinator Oct 5, 2007

All facility ownership & control disclosures 3

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Twin Oaks Convalescent CenterAlma, GA, CCN 115513 Skilled nursing facility Operational/Managerial Control Nov 26, 2007
Bacon County Community Care CenterAlma, GA, CCN 113408 Rural health clinic 5% Or Greater Direct Ownership Interest
Operational/Managerial Control		 Dec 17, 2012
Nov 20, 2002
Nicholls Family HealthcareNicholls, GA, CCN 118560 Rural health clinic Operational/Managerial Control (100%) Jul 10, 2017

Owned or controlled facilities with NPI records 3

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Affiliated clinicians 3

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1179187200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1205280000000",
    "number": "1245446699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "302 S WAYNE ST",
            "address_2": "P O DRAWER 1987",
            "city": "ALMA",
            "state": "GA",
            "postal_code": "315102922",
            "telephone_number": "912-632-8961",
            "fax_number": "912-632-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "302 S WAYNE ST",
            "city": "ALMA",
            "state": "GA",
            "postal_code": "315102922",
            "telephone_number": "912-632-8961",
            "fax_number": "912-632-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BACON COUNTY HEALTH SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-15",
        "last_updated": "2008-03-12",
        "status": "A",
        "authorized_official_last_name": "TURNER",
        "authorized_official_first_name": "CINDY",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "912-632-8961",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "275N00000X",
            "taxonomy_group": "",
            "desc": "Medicare Defined Swing Bed Unit",
            "state": "GA",
            "license": "003-010",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alma, GA

Sources for this page

Verify at the official NPI Registry.