NPIMap

Organization Active NPI

Tri-Med Family Care, Inc

  • Federally Qualified Health Center (FQHC)
  • Ringgold, GA
National Provider Identifier
1356596399
Registry record updated Nov 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
TRI-MED FAMILY CARE, INC
Practice address
6120 Alabama Hwy
Ringgold, GA 30736-2804
Phone
(706) 935-6442
Fax
(706) 935-6445
NPI assigned
Nov 18, 2008
Last updated
Nov 21, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2024

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

Authorized official

Name
Suzanne Chovanec
Title
Ceo
Phone
(706) 935-6442

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Clinic/Center 261QC1500X
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

6120 Alabama Hwy
Ringgold, GA 30736-2804

Mailing address

PO Box 729
Ringgold, GA 30736-0729
Phone (706) 935-6442

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20090203000508 GA Part B Supplier - Clinic/Group Practice 8527122712 Receives reassigned benefits from 8 practitioners
1 other NPI on this enrollment
Practice locations: Ringgold, GA
O20131115001789 GA Part A Provider - Federally Qualified Health Center (FQHC) 8527122712 Practice locations: Ringgold, GA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1356596399. Details of each certification follow.

Federally qualified health center certification: CCN 111967

Legal name
TRI-MED FAMILY CARE, INC
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Nov 15, 2013
Last certification
Nov 15, 2013
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Aug 25, 2000 in GA
Enrollment address
6120 Alabama Hwy
Ringgold, GA 30736-2804

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
North Georgia Healthcare3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Ownership & related parties

All disclosed owners & managing parties 5

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Jerry Sims Individual Corporate DirectorBoard Member Jan 1, 2009
Emerson Russell Individual Corporate DirectorBoard Member Jan 1, 2018
Carol Fincher Individual Corporate DirectorBoard Member Jan 1, 2014
Suzanne Chovanec Individual Corporate DirectorDirector of Operations Jul 1, 2022
W-2 Managing Employee Jul 1, 2022
Natalie Hunt Individual Corporate DirectorBoard Member Jan 1, 2014

Practitioners & affiliated clinicians

Practitioners 10

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": "1226966400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1732147200000",
    "number": "1356596399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 729",
            "city": "RINGGOLD",
            "state": "GA",
            "postal_code": "307360729",
            "telephone_number": "706-935-6442",
            "fax_number": "706-935-6449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6120 ALABAMA HWY",
            "city": "RINGGOLD",
            "state": "GA",
            "postal_code": "307362804",
            "telephone_number": "706-935-6442",
            "fax_number": "706-935-6445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRI-MED FAMILY CARE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-11-18",
        "last_updated": "2024-11-21",
        "certification_date": "2024-11-21",
        "status": "A",
        "authorized_official_last_name": "CHOVANEC",
        "authorized_official_first_name": "SUZANNE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "706-935-6442"
    },
    "taxonomies": [
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ringgold, GA

Sources for this page

Verify at the official NPI Registry.