Organization Active NPI

Partners in Health LLC

  • Family Medicine Physician
  • Brunswick, GA
National Provider Identifier
1346588324
Registry record updated Jul 24, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
064606 Issued in GA
Legal business name
PARTNERS IN HEALTH LLC
Practice address
118 Northpark Dr
Brunswick, GA 31520-2111
Phone
(912) 268-4994
Fax
(912) 434-9096
NPI assigned
Jan 25, 2013
Last updated
Jul 24, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2013

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

Authorized official

Name
Mrs. Patsy J Mitchell, DONPI 1588720601
Title
Owner
Phone
(912) 264-6303

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 064606 GA Primary

Addresses

Primary practice location

118 Northpark Dr
Brunswick, GA 31520-2111

Mailing address

118 Northpark Dr
Brunswick, GA 31520-2111
Phone (912) 268-4994

Other identifiers 1

IdentifierTypeStateIssuer
003134432AMedicaidGA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130709000739 GA Part B Supplier - Clinic/Group Practice 4284874546 Receives reassigned benefits from 3 practitioners
Practice locations: Brunswick, GA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
11D2062753Partners in Health, LLC118 Northpark Drive, Brunswick, GA 31520Certificate of waiverJul 21, 2027

National Provider Directory

National Provider Directory

Locations

118 Northpark Dr
Brunswick, GA 31520
Phone (912) 265-5035

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/DJHCDA

Practitioners & affiliated clinicians

Practitioners 3

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": "1359072000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1374624000000",
    "number": "1346588324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "118 NORTHPARK DR",
            "city": "BRUNSWICK",
            "state": "GA",
            "postal_code": "315202111",
            "telephone_number": "912-268-4994",
            "fax_number": "912-434-9096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "118 NORTHPARK DR",
            "city": "BRUNSWICK",
            "state": "GA",
            "postal_code": "315202111",
            "telephone_number": "912-268-4994",
            "fax_number": "912-434-9096"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARTNERS IN HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-01-25",
        "last_updated": "2013-07-24",
        "status": "A",
        "authorized_official_last_name": "MITCHELL",
        "authorized_official_first_name": "PATSY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "912-264-6303",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "064606",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003134432A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brunswick, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.