The Hospital Authority of Habersham County

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

4705360 Issued in GA

Legal business name

THE HOSPITAL AUTHORITY OF HABERSHAM COUNTY

Doing business as

PrimeCare

Practice address

541 Historic Hwy 441 N
Demorest, GA 30535-4528

Phone

(706) 754-2273

Fax

(706) 754-7300

NPI assigned

Mar 13, 2007

Organization subpart

Yes

Parent organization

THE HOSPITAL AUTHORITY OF HABERSHAM COUNTYAs reported in NPPES

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

Authorized official

Name

Mr. James A Peterson

Title

Sr. VP of Finance

Phone

(706) 754-3113

Specialties & licenses 1

Addresses

Other identifiers 5

Other names 1

• PrimeCare Doing business as

Part of

The Hospital Authority of Habersham County

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• The Hospital Authority of Habersham County

  • Pharmacy
  • Demorest, GA
  • NPI 1548644586
  NPPES parent name

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

{
    "created_epoch": "1173744000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1395792000000",
    "number": "1346373180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "396 HISTORIC HIGHWAY 441 N",
            "city": "DEMOREST",
            "state": "GA",
            "postal_code": "30535",
            "telephone_number": "706-754-2273",
            "fax_number": "706-754-7300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "541 HISTORIC HWY 441 N",
            "city": "DEMOREST",
            "state": "GA",
            "postal_code": "305354528",
            "telephone_number": "706-754-2273",
            "fax_number": "706-754-7300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE HOSPITAL AUTHORITY OF HABERSHAM COUNTY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "THE HOSPITAL AUTHORITY OF HABERSHAM COUNTY",
        "enumeration_date": "2007-03-13",
        "last_updated": "2014-03-26",
        "status": "A",
        "authorized_official_last_name": "PETERSON",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "SR. VP OF FINANCE",
        "authorized_official_telephone_number": "706-754-3113",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "4705360",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA #",
            "identifier": "11D0944659",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COVENANT ADMINISTRATORS #",
            "identifier": "231",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHOENIX HOME LIFE",
            "identifier": "2466081",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHSTAR PROVIDER #",
            "identifier": "0930",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MCR PROVIDER #",
            "identifier": "DA0733",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PrimeCare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Ravin Batuk Talati, M.D
• Kelly Elizabeth Taylor, ANP
• Kristie D Taylor, NP-C
• Semere Tesfamariam, MD
• The Habersham County Senior Center
• The Hospital Authority of Habersham County
• The Hospital Authority of Habersham County
• The Hospital Authority of Habersham County
• The Hospital Authority of Habersham County
• The Hospital Authority of Habersham County

• Family Medicine Physician in Demorest, GA
• Providers in Demorest, GA by specialty
• Family Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2014; 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.