NPIMap

Organization Active NPI

McIntosh County Board of Health

Doing business as McIntosh County Health Department

  • Public Health or Welfare Agency
  • Townsend, GA
National Provider Identifier
1316928930
Registry record updated Jan 7, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Public Health or Welfare AgencyTaxonomy code 251K00000X
Legal business name
MCINTOSH COUNTY BOARD OF HEALTH
Doing business as
McIntosh County Health Department
Practice address
1335 Ga Highway 57
Townsend, GA 31331-8130
Phone
(912) 832-5473
Fax
(912) 832-5509
NPI assigned
Nov 10, 2005
Last updated
Jan 7, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2015

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

Authorized official

Name
Stacy A Cooper
Title
District Billing Dept Coordinator
Phone
(912) 262-2347

Specialties & licenses 1

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

Addresses

Primary practice location

1335 Ga Highway 57
Townsend, GA 31331-8130

Mailing address

150 Scranton Connector
Brunswick, GA 31525-0540
Phone (912) 262-2347

Other identifiers 6

IdentifierTypeStateIssuer
000051818GMedicaidGA
000457938FMedicaidGA
000456508MMedicaidGA
000551944AMedicaidGA
000453219MMedicaidGA
FLU151OtherGAMEDICARE ID

Other names 1

  • McIntosh 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
O20150204000316 GA Part B Supplier - Mass Immunization (Roster Biller Only) 3476541020 Practice locations: Townsend, GA

National Provider Directory

National Provider Directory

Locations

103 Jefferson St
Darien, GA 31305
Phone (912) 437-4561

1335 GA Highway 57
Townsend, GA 31331
Phone (912) 832-5473

Practitioners & affiliated clinicians

Practitioners 5

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": "1131580800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1420588800000",
    "number": "1316928930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 SCRANTON CONNECTOR",
            "city": "BRUNSWICK",
            "state": "GA",
            "postal_code": "315250540",
            "telephone_number": "912-262-2347",
            "fax_number": "912-262-3036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1335 GA HIGHWAY 57",
            "city": "TOWNSEND",
            "state": "GA",
            "postal_code": "313318130",
            "telephone_number": "912-832-5473",
            "fax_number": "912-832-5509"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MCINTOSH COUNTY BOARD OF HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-10",
        "last_updated": "2015-01-07",
        "status": "A",
        "authorized_official_last_name": "COOPER",
        "authorized_official_first_name": "STACY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "DISTRICT BILLING DEPT COORDINATOR",
        "authorized_official_telephone_number": "912-262-2347"
    },
    "taxonomies": [
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000051818G",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000457938F",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000456508M",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000551944A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000453219M",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID",
            "identifier": "FLU151",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "McIntosh County Health Department",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Townsend, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2015; 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.