Albany Area Primary Health Care, Inc.
Organization Active NPI Federally Qualified Health Center (FQHC) · Edison, GA
NPI 1366477838 · NPPES record last updated Jul 1, 2025
Key facts
- NPI
- 1366477838
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Federally Qualified Health Center (FQHC) 261QF0400X
- Legal business name
- ALBANY AREA PRIMARY HEALTH CARE, INC.
- Practice address
- 19519 Hartford St
Edison, GA 39846-5803 - Phone
- (229) 835-2238
- Fax
- (229) 835-3032
- NPI assigned
- Jul 12, 2006
- Organization subpart
- No
Authorized official
- Name
- Shelley Spires
- Title
- Ceo
- Phone
- (229) 888-6559
Other NPIs on the same Medicare enrollment 34
Corporate family (same tax ID) 33
Practitioners 15
-
Courtney Michele Chapman, D.D.S.
-
Daniel S Roberson, PA-C
-
Melissa Hunt Dozier, FNP
-
Rupert Dyer, D.O.
-
James Hotz, M.D.
-
Robyn Mann Johnson, M.D.
-
William McPeters, M.D.
-
Tania Smith, M.D.
-
Anita A Dhople, MD
-
Michelle L Hyla, DO
-
Sanjay Yadav, M.D.
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 11D0693708 | Edison Medical Center | Certificate of waiver | Sep 21, 2027 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in GA
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
- Corporation · Non-profit
- Enrollment address
- 19519 Hartford St
Edison, GA 39846-5803
All disclosed owners & managing parties 14
| Name | Role | Since | Share |
|---|---|---|---|
| Cassandra Daniels |
Corporate Director |
May 1, 2020 | |
| Elizabeth J West |
Corporate Director |
May 1, 1998 | |
| Brad R Stafford |
Corporate Director |
Jan 1, 2006 | |
| Willie M McNair |
Corporate Director |
Apr 24, 2025 | |
| Brenda C Williams |
Corporate Director |
Nov 1, 1992 | |
| Kuanita Murphy |
Corporate Director |
Sep 1, 2011 | |
| William J Peterson |
Corporate Director |
May 1, 2013 | |
| Victoria Darrisaw |
Corporate Director |
Nov 1, 2021 | |
| Robert Sternenberg |
Corporate Director |
Feb 1, 2013 | |
| Chester B Floyd |
Corporate Director |
May 22, 2025 | |
| Sybil L Thomas |
Corporate Director |
Dec 1, 2007 | |
| Jimmy D Quinn |
Corporate Director |
Jul 1, 2008 | |
| Shelley Spires |
Corporate Officer |
Sep 4, 2015 | |
| W-2 Managing Employee |
Sep 4, 2015 | ||
| Douglas W Patten |
Corporate Director |
Dec 1, 2008 |
All facility ownership & control disclosures 18
| Facility | Type | Role | Since |
|---|---|---|---|
| Mirian Worthy Women'S Health Center |
Federally qualified health center | Operational/Managerial Control (100%) | Nov 29, 1979 |
| West Albany Dental & Medical Center |
Federally qualified health center | Operational/Managerial Control | Jun 14, 2011 |
| S.Trussell Medical Center |
Federally qualified health center | Operational/Managerial Control (100%) | Jun 1, 2010 |
| Rural HIV Model Thomasville |
Federally qualified health center | Operational/Managerial Control (100%) | Nov 29, 1979 |
| Alice Coachman Elementary School-Based Health Center |
Federally qualified health center | Operational/Managerial Control (100%) | Nov 29, 1979 |
| Albany Middle School-Based Health Center |
Federally qualified health center | Operational/Managerial Control (100%) | Nov 29, 1979 |
| Dooly County School-Based Health Center |
Federally qualified health center | Operational/Managerial Control (100%) | Nov 29, 1979 |
| Aaphc Renaissance Center |
Federally qualified health center | Operational/Managerial Control (100%) | Nov 29, 1979 |
| Terrell County School-Based Health Center |
Federally qualified health center | Operational/Managerial Control (100%) | Nov 29, 1979 |
| Hotz Scoggins Family Medical Center |
Federally qualified health center | Operational/Managerial Control (100%) | Nov 29, 1979 |
| Robert Harvey Elementary School-Based Health Center |
Federally qualified health center | Operational/Managerial Control (100%) | Nov 29, 1979 |
| Live Oak Elementary School-Based Health Center |
Federally qualified health center | Operational/Managerial Control (100%) | Nov 29, 1979 |
| Aaphc Americus Behavioral Wellness Center |
Federally qualified health center | Operational/Managerial Control (100%) | Nov 29, 1979 |
| Mitchell County School-Based Health Center |
Federally qualified health center | Operational/Managerial Control (100%) | Nov 29, 1979 |
| Albany Area Pediatrics |
Federally qualified health center | Operational/Managerial Control (100%) | Nov 29, 1979 |
| Aaphc Elois Edge Women'S Health Center |
Federally qualified health center | Operational/Managerial Control (100%) | Nov 29, 1979 |
| Albany Area Primary Health Care, Inc |
Federally qualified health center | Operational/Managerial Control (100%) | Nov 29, 1979 |
| Albany Area Primary Health Care, Inc |
Federally qualified health center | Operational/Managerial Control (100%) | Nov 29, 1979 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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 |
National Provider Directory
- Tax ID family
- East Albany Medical Ctr
Locations
1700 Cordell Ave
Albany, GA 31705
Phone (229) 405-6235
11949 US Highway 41
Pinehurst, GA 31070
Phone (229) 405-6249
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Federally Qualified Health Center (FQHC) | 261QF0400X | Yes |
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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000674737A | Medicaid | GA | |
| CG1481 | Other | RR MEDICARE | |
| 000674737B | Medicaid | GA |
Other names
- Edison Medical Center
Other providers in Edison, GA
- 464 Wellness Solutions LLC
- Calhoun County Special Education
- Shemika L Cox
- Melissa Hunt Dozier
- Edison Pharmacy LLC
- Abigail Jessica Glass
All providers in Edison, GA · Federally Qualified Health Center (FQHC) in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 1, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.