Organization Active NPI

Carroll County Board of Health

Doing business as Carroll County Health Department

  • State or Local Public Health Clinic/Center
  • Carrollton, GA
National Provider Identifier
1326049289
Registry record updated Dec 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
State or Local Public Health Clinic/CenterTaxonomy code 261QP0905X
Legal business name
CARROLL COUNTY BOARD OF HEALTH
Doing business as
Carroll County Health Department
Practice address
1004 Newnan Rd
Carrollton, GA 30116-6428
Phone
(770) 836-6667
Fax
(770) 836-6722
NPI assigned
Aug 2, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2025

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

Authorized official

Name
Kylie Myhand
Title
Billing Supervisor
Phone
(706) 298-7709

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered NurseGroup: 193200000X MULTI-SPECIALTY GROUP 163W00000X
Public Health or Welfare Agency 251K00000X GA
State or Local Public Health Clinic/Center 261QP0905X Primary

Addresses

Primary practice location

1004 Newnan Rd
Carrollton, GA 30116-6428

Mailing address

1004 Newnan Rd
Carrollton, GA 30116-6428
Phone (770) 836-6667

Other identifiers 4

IdentifierTypeStateIssuer
00784308AMedicaidGA
00456453CMedicaidGA
00461744BMedicaidGA
00052093CMedicaidGA

Other names 1

  • Carroll 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
O20170808003055 GA Part B Supplier - Mass Immunization (Roster Biller Only) 8224026844 Practice locations: Carrollton, GA

National Provider Directory

National Provider Directory

Locations

1004 Newnan Rd
Carrollton, GA 30116
Phone (770) 836-6667

NPI Registry JSON

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

{
    "created_epoch": "1122940800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1764547200000",
    "number": "1326049289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1004 NEWNAN RD",
            "city": "CARROLLTON",
            "state": "GA",
            "postal_code": "301166428",
            "telephone_number": "770-836-6667",
            "fax_number": "770-836-6838"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1004 NEWNAN RD",
            "city": "CARROLLTON",
            "state": "GA",
            "postal_code": "301166428",
            "telephone_number": "770-836-6667",
            "fax_number": "770-836-6722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARROLL COUNTY BOARD OF HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-02",
        "last_updated": "2025-12-01",
        "certification_date": "2025-12-01",
        "status": "A",
        "authorized_official_last_name": "MYHAND",
        "authorized_official_first_name": "KYLIE",
        "authorized_official_title_or_position": "BILLING SUPERVISOR",
        "authorized_official_telephone_number": "706-298-7709"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": "GA",
            "license": null,
            "primary": false
        },
        {
            "code": "261QP0905X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Public Health, State or Local",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00784308A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00456453C",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00461744B",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00052093C",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Carroll County Health Department",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Carroll County Health Department",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Carrollton, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2025; 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.