NPIMap

Organization Active NPI

Healthstat on-Site Clinic/Milliken Live Oak

  • Preventive Medicine/Occupational Environmental Medicine Physician
  • Lagrange, GA
National Provider Identifier
1295160232
Registry record updated Sep 10, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Preventive Medicine/Occupational Environmental Medicine PhysicianTaxonomy code 2083P0500X
Legal business name
HEALTHSTAT ON-SITE CLINIC/MILLIKEN LIVE OAK
Practice address
300 Lukken Industrial Dr W
Lagrange, GA 30240-5916
Phone
(864) 545-2279
NPI assigned
Sep 10, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2013

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

Authorized official

Name
Warren Hutton
Title
Coo
Phone
(704) 529-6161

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Preventive Medicine/Occupational Environmental Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2083P0500X Primary

Addresses

Primary practice location

300 Lukken Industrial Dr W
Lagrange, GA 30240-5916

Mailing address

4651 Charlotte Park Dr
Suite 300
Charlotte, NC 28217-1956

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
11D1072858Healthstat Incorporate on Site Clinic300 Lukken Industrial Drive W, Lagrange, GA 30240Certificate of waiverAug 26, 2027

National Provider Directory

National Provider Directory
Tax ID family
Healthstat on-Site Clinicmilliken Kex237 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 19

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 19

Locations

300 Lukken Industrial Dr W
Lagrange, GA 30240
Phone (864) 545-2279

NPI Registry JSON

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

{
    "created_epoch": "1378771200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1378771200000",
    "number": "1295160232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4651 CHARLOTTE PARK DR",
            "address_2": "SUITE 300",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282171956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 LUKKEN INDUSTRIAL DR W",
            "city": "LAGRANGE",
            "state": "GA",
            "postal_code": "302405916",
            "telephone_number": "864-545-2279"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTHSTAT ON-SITE CLINIC/MILLIKEN LIVE OAK",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-09-10",
        "last_updated": "2013-09-10",
        "status": "A",
        "authorized_official_last_name": "HUTTON",
        "authorized_official_first_name": "WARREN",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "704-529-6161"
    },
    "taxonomies": [
        {
            "code": "2083P0500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lagrange, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.