Southern Health Corp of Ellijay

Primary specialty

Medicare Defined Swing Bed Hospital UnitTaxonomy code 275N00000X

License

061-435 Issued in GA

Legal business name

SOUTHERN HEALTH CORP OF ELLIJAY

Practice address

1362 S Main St
Ellijay, GA 30540-5410

Phone

(706) 276-4741

Fax

(706) 276-4745

NPI assigned

Jan 3, 2007

Organization subpart

No

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

Authorized official

Name

Ms. Debbie Self, CFO

Title

Chief Financial Officer

Phone

(706) 276-4741

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• NORTH GEORGIA MEDICAL CENTER Doing business as

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

{
    "created_epoch": "1167782400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1184025600000",
    "number": "1275690703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2239",
            "city": "ELLIJAY",
            "state": "GA",
            "postal_code": "305400025",
            "telephone_number": "706-276-4741",
            "fax_number": "706-276-4745"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1362 S MAIN ST",
            "city": "ELLIJAY",
            "state": "GA",
            "postal_code": "305405410",
            "telephone_number": "706-276-4741",
            "fax_number": "706-276-4745"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN HEALTH CORP OF ELLIJAY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-03",
        "last_updated": "2007-07-10",
        "status": "A",
        "authorized_official_last_name": "SELF",
        "authorized_official_first_name": "DEBBIE",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "706-276-4741",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "CFO"
    },
    "taxonomies": [
        {
            "code": "275N00000X",
            "taxonomy_group": "",
            "desc": "Medicare Defined Swing Bed Unit",
            "state": "GA",
            "license": "061-435",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GENERAL HOSPITAL",
            "identifier": "000692",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00002043S",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NORTH GEORGIA MEDICAL CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Susan J Smith, MD
• Michelle Davis Snearly, FNP-C
• Sonshine Manor
• Southern Health Corp of Ellijay
• Southern Health Corp of Ellijay
• Southern Health Corp of Ellijay
• Southern Health Corp of Ellijay
• Southern Health Corp of Ellijay
• Southern Health Corp of Ellijay
• Southern Health Corp of Ellijay

• Medicare Defined Swing Bed Hospital Unit in Ellijay, GA
• Providers in Ellijay, GA by specialty
• Medicare Defined Swing Bed Hospital Unit in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2007; 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.