NPIMap

Organization Active NPI

CRH Physician Practices LLC

Doing business as CRH Nicholls Clinic

  • Multi-Specialty Clinic/Center
  • Nicholls, GA
National Provider Identifier
1295095925
Registry record updated Jul 24, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
CRH PHYSICIAN PRACTICES LLC
Doing business as
CRH Nicholls Clinic
Practice address
804 N Liberty St
Nicholls, GA 31554
Phone
(912) 384-4024
Fax
(912) 384-4040
NPI assigned
May 29, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2018

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

Authorized official

Name
Vicki Lewis
Title
Ceo
Phone
(912) 384-1900

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X Primary

Addresses

Primary practice location

804 N Liberty St
Nicholls, GA 31554

Mailing address

1100 Ward Street Ext W
Douglas, GA 31533-1902
Phone (912) 384-1477

Other names 1

  • CRH Nicholls Clinic Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Coffee Regional6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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

Practitioners & affiliated clinicians

Practitioners 5

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": "1338249600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1532390400000",
    "number": "1295095925",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 WARD STREET EXT W",
            "city": "DOUGLAS",
            "state": "GA",
            "postal_code": "315331902",
            "telephone_number": "912-384-1477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "804 N LIBERTY ST",
            "city": "NICHOLLS",
            "state": "GA",
            "postal_code": "31554",
            "telephone_number": "912-384-4024",
            "fax_number": "912-384-4040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRH PHYSICIAN PRACTICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-29",
        "last_updated": "2018-07-24",
        "status": "A",
        "authorized_official_last_name": "LEWIS",
        "authorized_official_first_name": "VICKI",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "912-384-1900"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CRH Nicholls Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Nicholls, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2018; 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.