Oconee Community Service Board
Organization Active NPI Community/Behavioral Health Agency · Milledgeville, GA
NPI 1295922128 · NPPES record last updated Nov 11, 2021
Key facts
- NPI
- 1295922128
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community/Behavioral Health Agency 251S00000X
- Legal business name
- OCONEE COMMUNITY SERVICE BOARD
- Practice address
- 1239 Orchard Hill Rd
Milledgeville, GA 31061-2549 - Phone
- (478) 445-4721
- NPI assigned
- Sep 25, 2007
- Organization subpart
- No
Authorized official
- Name
- Ms. Jennifer Gheesling
- Title
- Office Systems Manager
- Phone
- (478) 445-4971
Other NPIs on the same Medicare enrollment 1
Practitioners 9
-
Michael Byrd, PMHNP
-
Howard N Caplan, M.D.
-
Keshana Snead, APRN
-
James C Sikes, MD
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20100812000021 | GA | Part B Supplier - Clinic/Group Practice | 1052392446 |
Receives reassigned benefits from 5 practitioners 1 other NPI on this enrollment Practice locations: Milledgeville, GA; Sandersville, GA |
National Provider Directory
Locations
143 E Haynes St
Sandersville, GA 31082
Phone (478) 553-3242
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Behavioral Health Agency | 251S00000X | Yes |
Addresses
Primary practice location
1239 Orchard Hill Rd
Milledgeville, GA 31061-2549
Mailing address
PO Box 1827
Milledgeville, GA 31059-1827
Phone (478) 445-4817
Other practice location 1
75 Boland Cir
Sparta, GA 31087-2007
Phone (706) 444-1037
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000604469AI | Medicaid | GA | |
| 000604469N | Medicaid | GA |
Other providers in Milledgeville, GA
- Oconee Community Service Board
- Oconee Community Service Board
- Oconee Community Service Board
- Oconee Community Service Board
- Oconee Community Service Board
- Oconee Community Service Board
- Oconee Community Service Board
- Oconee Community Service Board
- Oconee Community Service Board
- Oconee Community Service Board
All providers in Milledgeville, GA · Community/Behavioral Health Agency in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 11, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.