NPIMap

Organization Active NPI

Mitchell County Hospital

Doing business as The Pelham Clinic

  • Rural Health Clinic/Center
  • Pelham, GA
National Provider Identifier
1306046016
Registry record updated Apr 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
License
101-120 Issued in GA
Legal business name
MITCHELL COUNTY HOSPITAL
Doing business as
The Pelham Clinic
Practice address
167 Hand Ave W
Pelham, GA 31779-1268
Phone
(229) 294-2951
Fax
(229) 294-8146
NPI assigned
Jul 20, 2007
Last updated
Apr 25, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2019

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

Authorized official

Name
Greg Hembree
Title
Senior VP/Cfo
Phone
(229) 228-2853

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X 101-120 GA Primary

Addresses

Primary practice location

167 Hand Ave W
Pelham, GA 31779-1268

Mailing address

920 Cairo Rd
Thomasville, GA 31792-4255
Phone (229) 227-5500

Other names 1

  • The Pelham Clinic Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Archbold Mitchell10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

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

Practitioners & affiliated clinicians

Practitioners 1

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": "1184889600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1556150400000",
    "number": "1306046016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "920 CAIRO RD",
            "city": "THOMASVILLE",
            "state": "GA",
            "postal_code": "317924255",
            "telephone_number": "229-227-5500",
            "fax_number": "229-227-5501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "167 HAND AVE W",
            "city": "PELHAM",
            "state": "GA",
            "postal_code": "317791268",
            "telephone_number": "229-294-2951",
            "fax_number": "229-294-8146"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MITCHELL COUNTY HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-20",
        "last_updated": "2019-04-25",
        "status": "A",
        "authorized_official_last_name": "HEMBREE",
        "authorized_official_first_name": "GREG",
        "authorized_official_title_or_position": "SENIOR VP/CFO",
        "authorized_official_telephone_number": "229-228-2853"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "GA",
            "license": "101-120",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Pelham Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "The Pelham Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Pelham, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2019; 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.