Organization Active NPI

Dodge County Board of Health

Doing business as Dodge County Health Department

  • Public Health or Welfare Agency
  • Eastman, GA
National Provider Identifier
1316015407
Registry record updated Oct 12, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Public Health or Welfare AgencyTaxonomy code 251K00000X
Legal business name
DODGE COUNTY BOARD OF HEALTH
Doing business as
Dodge County Health Department
Practice address
1121 Plaza Ave
Eastman, GA 31023-6761
Phone
(478) 374-5576
Fax
(478) 374-0234
NPI assigned
Nov 30, 2006
Last updated
Oct 12, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2011

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

Authorized official

Name
Candace Spicer Christian
Title
Administrator
Phone
(478) 275-6545

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Public Health or Welfare Agency 251K00000X Primary

Addresses

Primary practice location

1121 Plaza Ave
Eastman, GA 31023-6761

Mailing address

1121 Plaza Ave
Eastman, GA 31023-6761
Phone (478) 374-5576

Other names 1

  • Dodge County Health Department Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080418000222 GA Part B Supplier - Mass Immunization (Roster Biller Only) 4183702954 Practice locations: Eastman, GA

National Provider Directory

National Provider Directory

Locations

3193 Howell Mill Rd NW
Ste 322
Atlanta, GA 30327
Phone (404) 352-3683

2711 Irvin Way
Ste 203
Decatur, GA 30030
Phone (404) 292-5010

465 Winn Way
Decatur, GA 30030
Phone (404) 663-4029

5255 Snapfinger Park Dr
Decatur, GA 30035
Phone (313) 969-7449

1121 Plaza Ave
Eastman, GA 31023
Phone (478) 374-5576

Practitioners & affiliated clinicians

Practitioners 10

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": "1164844800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1318377600000",
    "number": "1316015407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1121 PLAZA AVE",
            "city": "EASTMAN",
            "state": "GA",
            "postal_code": "310236761",
            "telephone_number": "478-374-5576",
            "fax_number": "478-374-0234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1121 PLAZA AVE",
            "city": "EASTMAN",
            "state": "GA",
            "postal_code": "310236761",
            "telephone_number": "478-374-5576",
            "fax_number": "478-374-0234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DODGE COUNTY BOARD OF HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-30",
        "last_updated": "2011-10-12",
        "status": "A",
        "authorized_official_last_name": "CHRISTIAN",
        "authorized_official_first_name": "CANDACE",
        "authorized_official_middle_name": "SPICER",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "478-275-6545"
    },
    "taxonomies": [
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dodge County Health Department",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Eastman, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2011; 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.