Oconee Valley Healthcare Inc
Organization Active NPI Federally Qualified Health Center (FQHC) · Eatonton, GA
NPI 1356102198 · NPPES record last updated Mar 28, 2024
Key facts
- NPI
- 1356102198
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Federally Qualified Health Center (FQHC) 261QF0400X
- Legal business name
- OCONEE VALLEY HEALTHCARE INC
- Practice address
- 114 Harmony Xing Ste 5
Eatonton, GA 31024-9546 - Phone
- (706) 454-1210
- Fax
- (762) 298-0799
- NPI assigned
- Jan 18, 2024
- Organization subpart
- No
Authorized official
- Name
- Dave Ringer, MD
- Title
- Ceo
- Phone
- (706) 453-1201
Owners & managing parties with NPI records 1
-
Dave A Ringer, MD
Owned or controlled facilities with NPI records 2
Other NPIs on the same Medicare enrollment 6
Other NPIs with the same Medicare PAC ID 6
Practitioners 26
-
Craig Colby, M.D.
-
Jennifer Dixon, NP
-
Benjamin Goodroe, MD
-
Abigail Register Millwood, APRN, FNP-BC, FNP-C
-
Dave A Ringer, MD
-
Nathan Wade, FNP
-
April Alleyne Wood, FNP-C
-
Jeffrey Lawrence Zweig, M.D.
-
Beverly Jean Cadwallader, PA-C
-
Carrie Emery Dawson, P.A.
-
Erica Starr Lang, FNP-BC
-
Steve M. Sinclair Jr., D.C.
-
Joshua M Lang, DO
-
Gregory Todd Milroy, M.D.
-
Andrew L Tam, DDS
-
John Anthony Wheeler, PHD, NCC, ACS, MDIV,
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 11D2297961 | Oconee Valley Healthcare, Inc | Certificate of waiver | Jan 24, 2028 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in GA
Federally qualified health center certification: CCN C21007
- Legal name
- OCONEE VALLEY HEALTHCARE INC
- Certification status
- Active
- Provider type (POS)
- Federally qualified health center
- Participating since
- May 24, 2024
- Last certification
- May 24, 2024
- Ownership / control type
- For profit – corporation
- Organization structure
- Corporation · Non-profit
- Incorporated
- Feb 22, 2008 in GA
- Enrollment address
- 114 Harmony Crossing
Ste 5
Eatonton, GA 31024-9546
All disclosed owners & managing parties 8
| Name | Role | Since | Share |
|---|---|---|---|
| Donna Chester |
Corporate Officer |
Oct 1, 2006 | |
| Rodricus Monford |
Corporate Officer |
Oct 1, 2006 | |
| Dave a Ringer |
Corporate Director |
Jun 13, 2013 | |
| W-2 Managing Employee | Jun 13, 2013 | ||
| Marc Lhowe |
Corporate Officer |
Oct 1, 2006 | |
| Morris Miller |
Corporate Officer |
Feb 21, 2013 | |
| Joan V Antone |
Corporate Officer |
Oct 1, 2006 | |
| Avis E Williams |
Corporate Officer |
Jan 19, 2006 | |
| Linda P McGhee |
Corporate Officer |
Oct 1, 2006 |
All facility ownership & control disclosures 2
| Facility | Type | Role | Since |
|---|---|---|---|
| Milledgeville |
Federally qualified health center | Operational/Managerial Control | Sep 12, 2013 |
| Oconee Valley Healthcare Inc |
Federally qualified health center | Operational/Managerial Control (100%) | Sep 12, 2013 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040604000755 | GA | Part B Supplier - Clinic/Group Practice | 0446232268 |
Receives reassigned benefits from 26 practitioners 6 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Milledgeville, GA; Greensboro, GA; Eatonton, GA |
| O20240524001381 | GA | Part a Provider - Federally Qualified Health Center (FQHC) | 0446232268 | Practice locations: Eatonton, GA |
National Provider Directory
Locations
114 Harmony Xing
Ste 5
Eatonton, GA 31024
Phone (706) 454-1210
114 Harmony Xing
Ste D
Eatonton, GA 31024
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Federally Qualified Health Center (FQHC) | 261QF0400X | Yes |
Addresses
Primary practice location
114 Harmony Xing Ste 5
Eatonton, GA 31024-9546
Mailing address
803 S Main St
Greensboro, GA 30642-1211
Phone (706) 453-1201
Other providers in Eatonton, GA
- Tressie Sheileen Nicholson
- Nra-Eatonton, Georgia, LLC
- O Akhras MD PC
- Oconee Community Service Board
- Oconee Health Services
- Oconee Valley Healthcare Inc
- Brenda D Parham
- Pathfinders Counseling Services, Inc.
- Rebecca Patrick
- Peaceful Purpose Hospice
All providers in Eatonton, GA · Federally Qualified Health Center (FQHC) in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 28, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.