South Central Primary Care Center, Inc

Primary specialty

Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X

Legal business name

SOUTH CENTRAL PRIMARY CARE CENTER, INC

Doing business as

PSYCHIATRIC AND COUNSELING SERVICES

Practice address

303 Shirley Ave Ste a
Douglas, GA 31533-2367

Phone

(912) 383-8806

Fax

(912) 383-8147

NPI assigned

Feb 22, 2018

Organization subpart

No

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

Authorized official

Name

Robert Bonds Tucker

Title

Ceo

Phone

(229) 468-9166

Specialties & licenses 1

Addresses

Other names 1

• PSYCHIATRIC AND COUNSELING SERVICES Doing business as

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

{
    "created_epoch": "1519257600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1732060800000",
    "number": "1295236503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 749",
            "city": "OCILLA",
            "state": "GA",
            "postal_code": "317740749",
            "telephone_number": "229-468-9166",
            "fax_number": "229-468-9188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303 SHIRLEY AVE STE A",
            "city": "DOUGLAS",
            "state": "GA",
            "postal_code": "315332367",
            "telephone_number": "912-383-8806",
            "fax_number": "912-383-8147"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH CENTRAL PRIMARY CARE CENTER, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-02-22",
        "last_updated": "2024-11-20",
        "certification_date": "2024-11-20",
        "status": "A",
        "authorized_official_last_name": "TUCKER",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "BONDS",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "229-468-9166"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PSYCHIATRIC AND COUNSELING SERVICES",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "PSYCHIATRIC AND COUNSELING SERVICES",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Farah Smith, NP-C
• Matthew Oliver Smith, D.M.D.
• Robert Lynwood Smith, M.D.
• Teresa Smith, PHARMD
• South Central Primary Care Center, Inc
• South Central Primary Care Center, Inc
• South Central Primary Care Center, Inc.
• South Georgia Cosmetic & General Dentistry
• South Georgia Eye Partners PC
• South Georgia Therapy Center

• Federally Qualified Health Center (FQHC) in Douglas, GA
• Providers in Douglas, GA by specialty
• Federally Qualified Health Center (FQHC) in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2024; 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.