NPIMap

Organization Active NPI

Crisp RGNL Hosp Inc

  • Durable Medical Equipment & Medical Supplies
  • Hawkinsville, GA
National Provider Identifier
1356547145
Registry record updated Dec 18, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
License
10401446 Issued in GA
Legal business name
CRISP RGNL HOSP INC
Practice address
440 Industrial Blvd
Hawkinsville, GA 31036
Phone
(478) 783-4988
Fax
(800) 342-7671
NPI assigned
Jun 27, 2007
Last updated
Dec 18, 2007By the provider in NPPES
Organization subpart
Yes
Parent organization
CRISP REGIONAL HOSPITAL INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 18, 2007

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

Authorized official

Name
Mark Petermann
Title
Administrator
Phone
(229) 273-1481

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X 10401446 GA Primary

Addresses

Primary practice location

440 Industrial Blvd
Hawkinsville, GA 31036

Mailing address

PO Box 1033
Hawkinsville, GA 31036-7033
Phone (478) 783-4988

National Provider Directory

National Provider Directory
Tax ID family
Surgical Associates22 organizations share this tax ID, including this one
Part of
Surgical Associates

Other organizations with this tax ID 21

Organizations that report the same tax identification number in the National Provider Directory.

View all 21

NPI Registry JSON

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

{
    "created_epoch": "1182902400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1197936000000",
    "number": "1356547145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1033",
            "city": "HAWKINSVILLE",
            "state": "GA",
            "postal_code": "310367033",
            "telephone_number": "478-783-4988",
            "fax_number": "800-342-7671"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "440 INDUSTRIAL BLVD",
            "city": "HAWKINSVILLE",
            "state": "GA",
            "postal_code": "31036",
            "telephone_number": "478-783-4988",
            "fax_number": "800-342-7671"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRISP RGNL HOSP INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CRISP REGIONAL HOSPITAL INC",
        "enumeration_date": "2007-06-27",
        "last_updated": "2007-12-18",
        "status": "A",
        "authorized_official_last_name": "PETERMANN",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "229-273-1481"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "GA",
            "license": "10401446",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hawkinsville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2007; 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.