NPIMap

Organization Active NPI

TMC-Behavioral Health of West Georgia

Doing business as Behavioral Health of West Georgia

  • Geriatric Psychiatry Physician
  • Villa Rica, GA
National Provider Identifier
1356795462
Registry record updated Feb 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Psychiatry PhysicianTaxonomy code 2084P0805X
Legal business name
TMC-BEHAVIORAL HEALTH OF WEST GEORGIA
Doing business as
Behavioral Health of West Georgia
Practice address
101 Quartz Dr Ste 103B
Villa Rica, GA 30180-3201
Phone
(770) 812-3530
Fax
(770) 812-3531
NPI assigned
Apr 15, 2016
Last updated
Feb 29, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 29, 2024

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

Authorized official

Name
Jillian Ragsdale
Title
VP of Finance
Phone
(770) 838-8710

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Psychiatry Physician 2084P0805X NU Primary

Addresses

Primary practice location

101 Quartz Dr Ste 103B
Villa Rica, GA 30180-3201

Mailing address

100 Greenway Blvd FL 2
Carrollton, GA 30117-4338
Phone (770) 838-8710

Other names 1

  • Behavioral Health of West Georgia Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, AL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20160705000347 GA Part B Supplier - Clinic/Group Practice 2163714635 Receives reassigned benefits from 65 practitioners
Practice locations: Villa Rica, GA; Carrollton, GA
O20240429001202 AL Part B Supplier - Clinic/Group Practice 2163714635 Receives reassigned benefits from 3 practitioners
Practice locations: Wedowee, AL

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

100 Greenway Blvd
Ste C
Carrollton, GA 30117
Phone (770) 838-8710

1600 Maple St
Carrollton, GA 30118
Phone (718) 839-6452

523 Dixie St
Ste 4
Carrollton, GA 30117
Phone (770) 834-8327

706 Dixie St
Ste 220
Carrollton, GA 30117
Phone (770) 812-8825

958 Joe Frank Harris Pkwy SE
Ste 103
Cartersville, GA 30120
Phone (770) 387-8188

985 Joe Frank Harris Pkwy SE
Ste 103
Cartersville, GA 30120
Phone (770) 812-3380

101 Quartz Dr
Ste 103B
Villa Rica, GA 30180
Phone (770) 812-3580

Practitioners & affiliated clinicians

Practitioners 84

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.

View all 84

NPI Registry JSON

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

{
    "created_epoch": "1460678400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1709164800000",
    "number": "1356795462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 GREENWAY BLVD FL 2",
            "city": "CARROLLTON",
            "state": "GA",
            "postal_code": "301174338",
            "telephone_number": "770-838-8710",
            "fax_number": "770-812-5735"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 QUARTZ DR STE 103B",
            "city": "VILLA RICA",
            "state": "GA",
            "postal_code": "301803201",
            "telephone_number": "770-812-3530",
            "fax_number": "770-812-3531"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TMC-BEHAVIORAL HEALTH OF WEST GEORGIA",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-15",
        "last_updated": "2024-02-29",
        "certification_date": "2024-02-29",
        "status": "A",
        "authorized_official_last_name": "RAGSDALE",
        "authorized_official_first_name": "JILLIAN",
        "authorized_official_title_or_position": "VP OF FINANCE",
        "authorized_official_telephone_number": "770-838-8710"
    },
    "taxonomies": [
        {
            "code": "2084P0805X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Geriatric Psychiatry",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Behavioral Health of West Georgia",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Behavioral Health of West Georgia",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Villa Rica, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 29, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.