NPIMap

Organization Active NPI

Albany Area Primary Health Care, Inc.

Doing business as Edison Medical Center

  • Federally Qualified Health Center (FQHC)
  • Edison, GA
National Provider Identifier
1366477838
Registry record updated Jul 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
ALBANY AREA PRIMARY HEALTH CARE, INC.
Doing business as
Edison Medical Center
Practice address
19519 Hartford St
Edison, GA 39846-5803
Phone
(229) 835-2238
Fax
(229) 835-3032
NPI assigned
Jul 12, 2006
Last updated
Jul 1, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2025

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

Authorized official

Name
Shelley Spires
Title
Ceo
Phone
(229) 888-6559

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

19519 Hartford St
Edison, GA 39846-5803

Mailing address

2408 Westgate Dr
Albany, GA 31707-2277
Phone (229) 888-6559

Other identifiers 3

IdentifierTypeStateIssuer
000674737BMedicaidGA
000674737AMedicaidGA
CG1481OtherRR MEDICARE

Other names 1

  • Edison Medical Center Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040217000509 GA Part B Supplier - Clinic/Group Practice 7911811922 Receives reassigned benefits from 129 practitioners
34 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Albany, GA; Americus, GA; Camilla, GA; Cordele, GA; Dawson, GA; Edison, GA; Fort Gaines, GA; Leesburg, GA…
O20050920001108 GA Part A Provider - Federally Qualified Health Center (FQHC) 7911811922 Practice locations: Edison, GA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1366477838. Details of each certification follow.

Federally qualified health center certification: CCN 111849

Legal name
ALBANY AREA PRIMARY HEALTH CARE, INC
Doing business as
EDISON MEDICAL CENTER
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Nov 1, 1997
Last certification
Nov 1, 1997
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Enrollment address
19519 Hartford St
Edison, GA 39846-5803

Other NPIs on the same Medicare enrollment 34

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

View all 34

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
11D0693708Edison Medical Center19519 W Hartford Street, Edison, GA 39846Certificate of waiverSep 21, 2027

National Provider Directory

National Provider Directory
Tax ID family
Albany Area Prim Hlthca34 organizations share this tax ID, including this one

Other organizations with this tax ID 33

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

View all 33

Locations

1412 W Oakridge Dr
Albany, GA 31707
Phone (229) 435-2424

200 Hobbs Ln
Fort Gaines, GA 39851
Phone (229) 394-4424

Ownership & related parties

All disclosed owners & managing parties 14

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

NameRoleSinceShare
Cassandra Daniels Individual Corporate DirectorBoard Member May 1, 2020
Elizabeth J West Individual Corporate DirectorBoard Member May 1, 1998
Brad R Stafford Individual Corporate DirectorPresident Jan 1, 2006
Willie M McNair Individual Corporate DirectorBoard Member Apr 24, 2025
Brenda C Williams Individual Corporate DirectorBoard Member Nov 1, 1992
Kuanita Murphy Individual Corporate DirectorVice President Sep 1, 2011
William J Peterson Individual Corporate DirectorBoard Member May 1, 2013
Victoria Darrisaw Individual Corporate DirectorBoard Member Nov 1, 2021
Robert Sternenberg Individual Corporate DirectorTreasurer Feb 1, 2013
Chester B Floyd Individual Corporate DirectorBoard Member May 22, 2025
Sybil L Thomas Individual Corporate DirectorBoard Member Dec 1, 2007
Jimmy D Quinn Individual Corporate DirectorBoard Member Jul 1, 2008
Shelley Spires Individual Corporate OfficerCeo Sep 4, 2015
W-2 Managing EmployeeCeo Sep 4, 2015
Douglas W Patten Individual Corporate DirectorBoard Member Dec 1, 2008

All facility ownership & control disclosures 18

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Mirian Worthy Women's Health CenterAlbany, GA, CCN 111922 Federally qualified health center Operational/Managerial Control (100%) Nov 29, 1979
West Albany Dental & Medical CenterAlbany, GA, CCN 111940 Federally qualified health center Operational/Managerial Control Jun 14, 2011
S.Trussell Medical CenterVienna, GA, CCN 111941 Federally qualified health center Operational/Managerial Control (100%) Jun 1, 2010
Rural HIV Model ThomasvilleThomasville, GA, CCN 111965 Federally qualified health center Operational/Managerial Control (100%) Nov 29, 1979
Alice Coachman Elementary School-Based Health CenterAlbany, GA, CCN 111025 Federally qualified health center Operational/Managerial Control (100%) Nov 29, 1979
Albany Middle School-Based Health CenterAlbany, GA, CCN 111023 Federally qualified health center Operational/Managerial Control (100%) Nov 29, 1979
Dooly County School-Based Health CenterPinehurst, GA, CCN 111032 Federally qualified health center Operational/Managerial Control (100%) Nov 29, 1979
Aaphc Renaissance CenterAlbany, GA, CCN 111033 Federally qualified health center Operational/Managerial Control (100%) Nov 29, 1979
Terrell County School-Based Health CenterDawson, GA, CCN 111034 Federally qualified health center Operational/Managerial Control (100%) Nov 29, 1979
Hotz Scoggins Family Medical CenterAlbany, GA, CCN 111036 Federally qualified health center Operational/Managerial Control (100%) Nov 29, 1979
Robert Harvey Elementary School-Based Health CenterAlbany, GA, CCN 111083 Federally qualified health center Operational/Managerial Control (100%) Nov 29, 1979
Live Oak Elementary School-Based Health CenterAlbany, GA, CCN 111081 Federally qualified health center Operational/Managerial Control (100%) Nov 29, 1979
Aaphc Americus Behavioral Wellness CenterAmericus, GA, CCN 851166 Federally qualified health center Operational/Managerial Control (100%) Nov 29, 1979
Mitchell County School-Based Health CenterCamilla, GA, CCN 851167 Federally qualified health center Operational/Managerial Control (100%) Nov 29, 1979
Albany Area PediatricsAlbany, GA, CCN 851174 Federally qualified health center Operational/Managerial Control (100%) Nov 29, 1979
Aaphc Elois Edge Women's Health CenterAlbany, GA, CCN 111155 Federally qualified health center Operational/Managerial Control (100%) Nov 29, 1979
Albany Area Primary Health Care, IncFort Gaines, GA, CCN 851965 Federally qualified health center Operational/Managerial Control (100%) Nov 29, 1979
Albany Area Primary Health Care, IncAmericus, GA, CCN 851967 Federally qualified health center Operational/Managerial Control (100%) Nov 29, 1979

Practitioners & affiliated clinicians

Practitioners 15

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 15

NPI Registry JSON

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

{
    "created_epoch": "1152662400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1751328000000",
    "number": "1366477838",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2408 WESTGATE DR",
            "city": "ALBANY",
            "state": "GA",
            "postal_code": "317072277",
            "telephone_number": "229-888-6559",
            "fax_number": "229-436-4107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19519 HARTFORD ST",
            "city": "EDISON",
            "state": "GA",
            "postal_code": "398465803",
            "telephone_number": "229-835-2238",
            "fax_number": "229-835-3032"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALBANY AREA PRIMARY HEALTH CARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-12",
        "last_updated": "2025-07-01",
        "certification_date": "2025-07-01",
        "status": "A",
        "authorized_official_last_name": "SPIRES",
        "authorized_official_first_name": "SHELLEY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "229-888-6559"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000674737B",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000674737A",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "CG1481",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Edison Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Edison, GA

Sources for this page

Verify at the official NPI Registry.