NPIMap

Organization Active NPI

Jasper Health Services Inc.

  • Critical Access Hospital Clinic/Center
  • Monticello, GA
National Provider Identifier
1275314767
Registry record updated Oct 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Access Hospital Clinic/CenterTaxonomy code 261QC0050X
Legal business name
JASPER HEALTH SERVICES INC.
Practice address
4100 Jackson Lake Rd
Monticello, GA 31064
Phone
(706) 468-4588
Fax
(706) 468-4589
NPI assigned
Oct 10, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2023

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

Authorized official

Name
Robert A Cumbie, PHARMD
Title
Administrator
Phone
(706) 468-4595

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Access Hospital Clinic/Center 261QC0050X Primary

Addresses

Primary practice location

4100 Jackson Lake Rd
Monticello, GA 31064

Mailing address

898 College St
Monticello, GA 31064-1258
Phone (706) 468-4595

Other names 1

  • Primary Care Center North Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040824001236 GA Part B Supplier - Clinic/Group Practice 7214901230 Receives reassigned benefits from 12 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Monticello, GA

Other NPIs on the same Medicare enrollment 1

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

National Provider Directory

National Provider Directory
Tax ID family
Jasper Health Services Inc4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Practitioners & affiliated clinicians

Practitioners 13

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1696896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1698192000000",
    "number": "1275314767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "898 COLLEGE ST",
            "city": "MONTICELLO",
            "state": "GA",
            "postal_code": "310641258",
            "telephone_number": "706-468-4595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4100 JACKSON LAKE RD",
            "city": "MONTICELLO",
            "state": "GA",
            "postal_code": "31064",
            "telephone_number": "706-468-4588",
            "fax_number": "706-468-4589"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JASPER HEALTH SERVICES INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-10-10",
        "last_updated": "2023-10-25",
        "certification_date": "2023-10-25",
        "status": "A",
        "authorized_official_last_name": "CUMBIE",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "706-468-4595",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "261QC0050X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Critical Access Hospital",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Primary Care Center North",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Primary Care Center North",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Monticello, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 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.