NPIMap

Organization Active NPI

Hospital Authority of Valdosta and Lowndes County Georgia

Doing business as South Georgia Medical Center

  • General Acute Care Hospital
  • Valdosta, GA
National Provider Identifier
1306896253
Registry record updated Aug 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
License
92141 Issued in GA
Legal business name
HOSPITAL AUTHORITY OF VALDOSTA AND LOWNDES COUNTY GEORGIA
Doing business as
South Georgia Medical Center
Practice address
2501 N Patterson St
Valdosta, GA 31602-1735
Phone
(229) 433-1000
NPI assigned
May 11, 2006
Last updated
Aug 14, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2023

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

Authorized official

Name
Mrs. Julie Hodges
Title
Controller
Phone
(229) 259-4140

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Mental Health Clinic/Center 261QM0850X 92141 GA
Adolescent and Children Mental Health Clinic/Center 261QM0855X 92141 GA
Urgent Care Clinic/Center 261QU0200X 92141 GA
General Acute Care Hospital 282N00000X 92141 GA Primary
Ambulance 341600000X 09201 GA

Addresses

Primary practice location

2501 N Patterson St
Valdosta, GA 31602-1735

Mailing address

PO Box 9
Valdosta, GA 31603-0009
Phone (229) 433-1000

Other practice location 1

4280 N Valdosta Rd
Valdosta, GA 31602-6814
Phone (229) 433-8000

Other identifiers 3

IdentifierTypeStateIssuer
000001724GMedicaidGA
000001724AMedicaidGA
000001724BMedicaidGA

Other names 1

  • South Georgia Medical Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040405001313 GA Part B Supplier - Clinic/Group Practice 1355334509 Receives reassigned benefits from 114 practitioners
13 other NPIs on this enrollment
Practice locations: Valdosta, GA; Nashville, GA; Lakeland, GA

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 13

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 13

National Provider Directory

National Provider Directory

Locations

2501 N Patterson St
Valdosta, GA 31602
Phone (229) 259-4139

Practitioners & affiliated clinicians

Practitioners 129

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.

View all 129

NPI Registry JSON

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

{
    "created_epoch": "1147305600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1691971200000",
    "number": "1306896253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316030009",
            "telephone_number": "229-433-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2501 N PATTERSON ST",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316021735",
            "telephone_number": "229-433-1000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4280 N Valdosta Rd",
            "address_purpose": "LOCATION",
            "city": "Valdosta",
            "state": "GA",
            "postal_code": "316026814",
            "country_code": "US",
            "telephone_number": "229-433-8000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "HOSPITAL AUTHORITY OF VALDOSTA AND LOWNDES COUNTY GEORGIA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-11",
        "last_updated": "2023-08-14",
        "certification_date": "2023-08-14",
        "status": "A",
        "authorized_official_last_name": "HODGES",
        "authorized_official_first_name": "JULIE",
        "authorized_official_title_or_position": "CONTROLLER",
        "authorized_official_telephone_number": "229-259-4140",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "GA",
            "license": "92141",
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": "GA",
            "license": "92141",
            "primary": false
        },
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": "GA",
            "license": "92141",
            "primary": false
        },
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "GA",
            "license": "92141",
            "primary": true
        },
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": "GA",
            "license": "09201",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000001724G",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000001724A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000001724B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "South Georgia Medical Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "South Georgia Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Valdosta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.