NPIMap

Organization Active NPI

Hospital Authority of Jenkins County

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Millen, GA
National Provider Identifier
1366315418
Registry record updated Sep 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
HOSPITAL AUTHORITY OF JENKINS COUNTY
Practice address
240 Walnut Street
Millen, GA 30432
Phone
(478) 982-4221
Fax
(478) 982-7822
NPI assigned
Sep 25, 2025
Last updated
Sep 25, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
HOSPITAL AUTHORITY OF JENKINS COUNTYAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 25, 2025

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

Authorized official

Name
Andrea Peek GrahamNPI 1891824827
Title
Ceo
Phone
(478) 982-4221

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary

Addresses

Primary practice location

240 Walnut Street
Millen, GA 30432

Mailing address

931 E Winthrope Ave
Millen, GA 30442-1839
Phone (478) 982-4221

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040401000747 GA Part B Supplier - Clinic/Group Practice 5193717833 Receives reassigned benefits from 3 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Millen, GA

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
Jenkins County Hospital4 organizations share this tax ID, including this one
Part of
Jenkins County Hospital

Other organizations with this tax ID 3

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

Practitioners & affiliated clinicians

Practitioners 4

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": "1758758400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1758758400000",
    "number": "1366315418",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "931 E WINTHROPE AVE",
            "city": "MILLEN",
            "state": "GA",
            "postal_code": "304421839",
            "telephone_number": "478-982-4221",
            "fax_number": "478-982-7822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "240 WALNUT STREET",
            "city": "MILLEN",
            "state": "GA",
            "postal_code": "30432",
            "telephone_number": "478-982-4221",
            "fax_number": "478-982-7822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOSPITAL AUTHORITY OF JENKINS COUNTY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "HOSPITAL AUTHORITY OF JENKINS COUNTY",
        "enumeration_date": "2025-09-25",
        "last_updated": "2025-09-25",
        "certification_date": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "GRAHAM",
        "authorized_official_first_name": "ANDREA",
        "authorized_official_middle_name": "PEEK",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "478-982-4221"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Millen, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2025; 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.