NPIMap

Organization Active NPI

The Medical Center of Peach County, Inc

Doing business as Atrium Health Navicent Primary Care Fort Valley

  • Rural Health Clinic/Center
  • Fort Valley, GA
National Provider Identifier
1275775314
Registry record updated Sep 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
THE MEDICAL CENTER OF PEACH COUNTY, INC
Doing business as
Atrium Health Navicent Primary Care Fort Valley
Valley Medical Center
Practice address
201 Avera Dr
Fort Valley, GA 31030-5008
Phone
(478) 825-7000
Fax
(478) 825-4478
NPI assigned
Apr 6, 2009
Last updated
Sep 29, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
THE MEDICAL CENTER OF PEACH COUNTY, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 29, 2025

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

Authorized official

Name
Philip Wheeler
Title
Cfo
Phone
(706) 509-3012

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X NU Primary

Addresses

Primary practice location

201 Avera Dr
Fort Valley, GA 31030-5008

Mailing address

1960 Hwy 247 Connector
Byron, GA 31008-5663
Phone (478) 654-2000

Other names 2

  • Atrium Health Navicent Primary Care Fort Valley Doing business as
  • Valley Medical Center Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other Ability Network

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20130402000222 GA Part B Supplier - Clinic/Group Practice 3375795693 Receives reassigned benefits from 4 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Fort Valley, GA; Byron, GA
O20130604000415 GA Part A Provider - Rural Health Clinic 3375795693 Practice locations: Fort Valley, GA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1275775314. Details of each certification follow.

Rural health clinic certification: CCN 118539

Legal name
THE MEDICAL CENTER OF PEACH COUNTY, INC.
Doing business as
ATRIUM HEALTH NAVICENT PRIMARY CARE FORT VALLEY
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Mar 20, 2012
Last certification
Jan 27, 2026
Ownership / control type
2B
Most recent change of ownership
Jan 1, 2013 (1 total)
Organization structure
CorporationNon-profit
Incorporated
Oct 26, 2011 in GA
Enrollment address
201 Avera Dr
Fort Valley, GA 31030-5008
Related CCNs
111310

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

Other NPIs with the same Medicare PAC ID 2

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

Other NPIs on the same Medicare enrollment 1

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

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
11D0950612Atrium Health Navicent Primary Care Fort Valley201 Avera Drive, Fort Valley, GA 31030Certificate of waiverAug 5, 2027

National Provider Directory

National Provider Directory
Part of
The Medical Center of Peach

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

201 Avera Dr
Fort Valley, GA 31030
Phone (478) 825-3317

Ownership & related parties

All disclosed owners & managing parties 11

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

NameRoleSinceShare
Laura Gentry Individual Corporate OfficerPresident/Ceo Feb 21, 2018
W-2 Managing EmployeeAd; Feb 21, 2018
Navicent Health Inc Organization, Macon, GA Corporation, Non-profit 5% Or Greater Direct Ownership Interest Nov 1, 2011 100%
David a Danzie Individual Corporate DirectorBoard Member Jan 1, 2026
Ah Georgia Inc Organization, Charlotte, NC Corporation, Holding company, Non-profit 5% Or Greater Indirect Ownership Interest Jan 1, 2019 100%
Adrienne S H Purdue Individual Corporate DirectorBoard Member Jan 1, 2026
Thomas M Green Individual Corporate OfficerChairman Nov 8, 2011
Corporate DirectorBoard Member Nov 8, 2011
The Charlotte-Mecklenburg Hospital Authority Organization, Charlotte, NC Corporation, Medical provider/supplier 5% Or Greater Indirect Ownership Interest Jan 1, 2019 100%
Philip Wheeler Individual Corporate OfficerTreasurer / Interim Cfo Jul 29, 2025
Erin P Snyder Individual Corporate OfficerSecretary Oct 18, 2023
Atrium Health Inc Organization, Charlotte, NC Corporation, Non-profit Operational/Managerial Control Oct 9, 2020
Advocate Health Inc Organization, Charlotte, NC Corporation, Non-profit Operational/Managerial Control Dec 2, 2022

Owners & managing parties with NPI records 5

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 94

Facilities that share an organizational owner with 5% or greater ownership or operational control.

  • Central Georgia Rehabilitation
    • Rehabilitation Hospital
    • Macon, GA
    • NPI 1366450710

    Advocate Health Inc, Ah Georgia Inc, Atrium Health Inc, Navicent Health Inc, The Charlotte-Mecklenburg Hospital Authority

    CMS ownership
  • Central Georgia Senior Health, Inc.

    dba Carlyle Place

    • Skilled Nursing Facility
    • Macon, GA
    • NPI 1609865112

    Advocate Health Inc, Ah Georgia Inc, Atrium Health Inc, Navicent Health Inc, The Charlotte-Mecklenburg Hospital Authority

    CMS ownership
  • Floyd Healthcare Management Inc

    dba Atrium Health Floyd Medical Center Behavioral Health

    • Psychiatric Hospital Unit
    • Rome, GA
    • NPI 1023057775

    Advocate Health Inc, Ah Georgia Inc, Atrium Health Inc, The Charlotte-Mecklenburg Hospital Authority

    CMS ownership
  • Floyd Healthcare Management Inc

    dba Atrium Health Floyd Medical Center

    • General Acute Care Hospital
    • Rome, GA
    • NPI 1154377166

    Advocate Health Inc, Ah Georgia Inc, Atrium Health Inc, The Charlotte-Mecklenburg Hospital Authority

    CMS ownership
  • Floyd Healthcare Management Inc

    dba Atrium Health Floyd Medical Center Heyman Hospice Care

    • Community Based Hospice Care Agency
    • Rome, GA
    • NPI 1699721399

    Advocate Health Inc, Ah Georgia Inc, Atrium Health Inc

    CMS ownership
  • Floyd Healthcare Management Inc

    dba Atrium Health Floyd Medical Center Rehabilitation

    • Rehabilitation Hospital Unit
    • Rome, GA
    • NPI 1801990213

    Advocate Health Inc, Ah Georgia Inc, Atrium Health Inc, The Charlotte-Mecklenburg Hospital Authority

    CMS ownership
  • Navicent Health Baldwin, Inc

    dba Atrium Health Navicent Baldwin

    • General Acute Care Hospital
    • Milledgeville, GA
    • NPI 1841701562

    Advocate Health Inc, Ah Georgia Inc, Atrium Health Inc, Navicent Health Inc, The Charlotte-Mecklenburg Hospital Authority

    CMS ownership
  • Navicent Health Baldwin, Inc

    dba Atrium Health Navicent Baldwin Skilled Nursing Unit

    • Skilled Nursing Facility
    • Milledgeville, GA
    • NPI 1912180878

    Advocate Health Inc, Ah Georgia Inc, Atrium Health Inc, Navicent Health Inc, The Charlotte-Mecklenburg Hospital Authority

    CMS ownership
  • Polk Medical Center, Inc

    dba Atrium Health Floyd Polk Medical Center

    • Critical Access Hospital
    • Cedartown, GA
    • NPI 1073927117

    Advocate Health Inc, Ah Georgia Inc, Atrium Health Inc, The Charlotte-Mecklenburg Hospital Authority

    CMS ownership
  • Polk Medical Center, Inc

    dba Atrium Health Floyd Polk Medical Center

    • Medicare Defined Swing Bed Hospital Unit
    • Cedartown, GA
    • NPI 1497169429

    Advocate Health Inc, Ah Georgia Inc, Atrium Health Inc, The Charlotte-Mecklenburg Hospital Authority

    CMS ownership
  • The Medical Center of Central Georgia Inc

    dba Atrium Health Navicent The Medical Center

    • General Acute Care Hospital
    • Macon, GA
    • NPI 1043270564

    Advocate Health Inc, Ah Georgia Inc, Atrium Health Inc, Navicent Health Inc, The Charlotte-Mecklenburg Hospital Authority

    CMS ownership
  • The Medical Center of Central Georgia Inc.

    dba Atrium Health Navicent Hospice Pine Pointe

    • Community Based Hospice Care Agency
    • Macon, GA
    • NPI 1760557953

    Advocate Health Inc, Ah Georgia Inc, Atrium Health Inc, Navicent Health Inc, The Charlotte-Mecklenburg Hospital Authority

    CMS ownership
View all 94

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 3

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": "1238976000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1759104000000",
    "number": "1275775314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1960 HWY 247 CONNECTOR",
            "city": "BYRON",
            "state": "GA",
            "postal_code": "310085663",
            "telephone_number": "478-654-2000",
            "fax_number": "478-654-2001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 AVERA DR",
            "city": "FORT VALLEY",
            "state": "GA",
            "postal_code": "310305008",
            "telephone_number": "478-825-7000",
            "fax_number": "478-825-4478"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE MEDICAL CENTER OF PEACH COUNTY, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "THE MEDICAL CENTER OF PEACH COUNTY, INC",
        "enumeration_date": "2009-04-06",
        "last_updated": "2025-09-29",
        "certification_date": "2025-09-29",
        "status": "A",
        "authorized_official_last_name": "WHEELER",
        "authorized_official_first_name": "PHILIP",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "706-509-3012"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.667.2",
            "affiliationName": "Ability Network",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "64 S Price Rd Ste B",
            "city": "Brownsville",
            "state": "TX",
            "country_code": "US",
            "postal_code": "785212459",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Atrium Health Navicent Primary Care Fort Valley",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Valley Medical Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Valley Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fort Valley, GA

Sources for this page

Verify at the official NPI Registry.