NPIMap

Organization Active NPI

Georgia Mountains Health Services, Inc.

  • Federally Qualified Health Center (FQHC)
  • Dahlonega, GA
National Provider Identifier
1285057281
Registry record updated May 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
GEORGIA MOUNTAINS HEALTH SERVICES, INC.
Practice address
134 Ansley Dr Ste 700
Dahlonega, GA 30533-1641
Phone
(706) 701-5001
Fax
(706) 701-5002
NPI assigned
Jan 27, 2014
Last updated
May 4, 2026By the provider in NPPES
Organization subpart
Yes
Parent organization
GEORGIA MOUNTAINS HEALTH SERVICES, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on May 4, 2026

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

Authorized official

Name
Andrew Stewart
Title
Ceo
Phone
(706) 946-5600

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X NU Primary
Urgent Care Clinic/Center 261QU0200X NU

Addresses

Primary practice location

134 Ansley Dr Ste 700
Dahlonega, GA 30533-1641

Mailing address

165 Blue Ridge Overlook
Blue Ridge, GA 30513-4431
Phone (706) 946-5607

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040429000383 GA Part B Supplier - Clinic/Group Practice 7719974831 Receives reassigned benefits from 33 practitioners
8 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Dahlonega, GA; La Fayette, GA; Ellijay, GA; Chatsworth, GA; Blue Ridge, GA
O20140430001851 GA Part A Provider - Federally Qualified Health Center (FQHC) 7719974831 Practice locations: Dahlonega, GA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1285057281. Details of each certification follow.

Federally qualified health center certification: CCN 111980

Legal name
GEORGIA MOUNTAINS HEALTH SERVICES, INC.
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Apr 30, 2014
Last certification
Apr 30, 2014
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Jun 19, 1985 in GA
Enrollment address
134 Ansley Dr
Ste 700
Dahlonega, GA 30533-1641

Other NPIs with the same Medicare PAC ID 8

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

Other NPIs on the same Medicare enrollment 6

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
11D2075825Georgia Mountains Health Services, Inc134 Ansley Drive, Suite 700, Dahlonega, GA 30533Certificate of waiverApr 6, 2028

National Provider Directory

National Provider Directory
Tax ID family
Georgia Mountns HLTH11 organizations share this tax ID, including this one
Part of
Georgia Mountns HLTH

Other organizations with this tax ID 10

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

Ownership & related parties

All disclosed owners & managing parties 13

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

NameRoleSinceShare
Steven Miracle Individual W-2 Managing EmployeeChief Executive Officer Jun 12, 2003 100%
Operational/Managerial ControlChief Executive Officer Jun 12, 2003 100%
Yaneth Garcia Individual Corporate Director Mar 20, 2022
Melissa P Sneads Individual Corporate Director Feb 17, 2021
Deborah S Peterson Individual Corporate Director Jan 1, 2012
Randy Westbrook Individual Corporate OfficerChief Financial Officer Sep 29, 2008
John H Rhodes Individual Corporate Director Jul 25, 2011
Ronald Stan Bafile Individual Corporate Director Mar 8, 2022
Marvin Chance Individual Corporate Director Jul 6, 2018
Patricia a Hampton Individual Corporate Director Apr 26, 2010
Janice C Glascock Individual Corporate Director Oct 2, 2017
Lloyd Gamison Phillips Individual Corporate Director Jan 12, 2010
Bianca Whittenbarger Individual Corporate Director May 1, 2014
Leonel Lopez Individual Corporate Director Sep 5, 2018

Practitioners & affiliated clinicians

Practitioners 20

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.

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1390780800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1777852800000",
    "number": "1285057281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "165 BLUE RIDGE OVERLOOK",
            "city": "BLUE RIDGE",
            "state": "GA",
            "postal_code": "305134431",
            "telephone_number": "706-946-5607",
            "fax_number": "706-374-7628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "134 ANSLEY DR STE 700",
            "city": "DAHLONEGA",
            "state": "GA",
            "postal_code": "305331641",
            "telephone_number": "706-701-5001",
            "fax_number": "706-701-5002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GEORGIA MOUNTAINS HEALTH SERVICES, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GEORGIA MOUNTAINS HEALTH SERVICES, INC.",
        "enumeration_date": "2014-01-27",
        "last_updated": "2026-05-04",
        "certification_date": "2026-05-04",
        "status": "A",
        "authorized_official_last_name": "STEWART",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "706-946-5600"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dahlonega, GA

Sources for this page

Verify at the official NPI Registry.