NPIMap

Organization Active NPI

Georgia Pines Community Service Board

  • Community/Behavioral Health Agency
  • Thomasville, GA
National Provider Identifier
1366506958
Registry record updated Jan 25, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
GEORGIA PINES COMMUNITY SERVICE BOARD
Practice address
1102 Smith Ave
Thomasville, GA 31792-5739
Phone
(229) 225-4335
Fax
(229) 225-4374
NPI assigned
Dec 20, 2006
Last updated
Jan 25, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2008

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

Authorized official

Name
Mr. Robert H Jones
Title
Executive Director
Phone
(229) 225-4373

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

1102 Smith Ave
Thomasville, GA 31792-5739

Mailing address

1102 Smith Ave
Thomasville, GA 31792-5739
Phone (229) 225-4335

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040429000631 GA Part B Supplier - Clinic/Group Practice 5799772844 Receives reassigned benefits from 54 practitioners
Practice locations: Bainbridge, GA; Thomasville, GA; Pelham, GA; Moultrie, GA; Donalsonville, GA; Cairo, GA

National Provider Directory

National Provider Directory

Locations

615 N Main St
Moultrie, GA 31768
Phone (229) 891-7374

1102 Smith Ave
Ste H
Thomasville, GA 31792
Phone (229) 225-5208

252 Woodlands Blvd
Thomasville, GA 31792
Phone (229) 221-1761

400 S Pinetree Blvd
Unit 414B
Thomasville, GA 31792

Practitioners & affiliated clinicians

Practitioners 61

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 61

NPI Registry JSON

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

{
    "created_epoch": "1166572800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1201219200000",
    "number": "1366506958",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1102 SMITH AVE",
            "city": "THOMASVILLE",
            "state": "GA",
            "postal_code": "317925739",
            "telephone_number": "229-225-4335",
            "fax_number": "229-225-4374"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1102 SMITH AVE",
            "city": "THOMASVILLE",
            "state": "GA",
            "postal_code": "317925739",
            "telephone_number": "229-225-4335",
            "fax_number": "229-225-4374"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GEORGIA PINES COMMUNITY SERVICE BOARD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-20",
        "last_updated": "2008-01-25",
        "status": "A",
        "authorized_official_last_name": "JONES",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "229-225-4373",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Thomasville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2008; 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.