The Baxley and Appling County Hospital Authority

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

68488 Issued in GA

Legal business name

THE BAXLEY AND APPLING COUNTY HOSPITAL AUTHORITY

Practice address

163 E Tollison St
Baxley, GA 31513-0120

Phone

(912) 367-9841

Fax

(912) 367-1272

NPI assigned

Oct 29, 2012

Organization subpart

Yes

Parent organization

THE BAXLEY AND APPLING COUNTY HOSPITAL AUTHORITYAs reported in NPPES

Name

Mr. Dale Spell

Title

Ceo

Phone

(912) 367-9841

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

• The Baxley and Appling County Hospital Authority

  • Pediatrics Physician
  • Baxley, GA
  • NPI 1437538501

  O20040108000489

  Same enrollment
• The Baxley and Appling County Hospital Authority

  • General Practice Physician
  • Baxley, GA
  • NPI 1518967116

  O20040108000489

  Same enrollment
• The Baxley and Appling County Hospital Authority

  • Rural Health Clinic/Center
  • Baxley, GA
  • NPI 1629217799

  O20040108000489

  Same enrollment
• The Baxley and Appling County Hospital Authority

  • Family Nurse Practitioner
  • Baxley, GA
  • NPI 1891149100

  O20040108000489

  Same enrollment
• The Baxley and Appling County Hospital Authority

  • Internal Medicine Physician
  • Baxley, GA
  • NPI 1972947752

  O20040108000489

  Same enrollment

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Josefina Cathryn Abendan Dubberly, M.D.

  • Pediatrics Physician
  • Baxley, GA
  • NPI 1124196928
  NPD
• Orlando V Fernando, M.D.

  • Internal Medicine Physician
  • Baxley, GA
  • NPI 1982663381
  NPD
• Michael Glenn Moss, MD

  • Internal Medicine Physician
  • Baxley, GA
  • NPI 1851554935
  NPD
• John Gary Wooley II, CRNA

  • Certified Registered Nurse Anesthetist
  • Douglas, GA
  • NPI 1760450316
  NPD

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Part of

Appling Healthcare Syst

• Appling Surgical Doing business as

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Nov 13, 2012.

{
    "created_epoch": "1351468800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1352764800000",
    "number": "1376897488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2070",
            "city": "BAXLEY",
            "state": "GA",
            "postal_code": "315152070",
            "telephone_number": "912-367-9841",
            "fax_number": "912-367-1272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "163 E TOLLISON ST",
            "city": "BAXLEY",
            "state": "GA",
            "postal_code": "315130120",
            "telephone_number": "912-367-9841",
            "fax_number": "912-367-1272"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE BAXLEY AND APPLING COUNTY HOSPITAL AUTHORITY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "THE BAXLEY AND  APPLING COUNTY HOSPITAL AUTHORITY",
        "enumeration_date": "2012-10-29",
        "last_updated": "2012-11-13",
        "status": "A",
        "authorized_official_last_name": "SPELL",
        "authorized_official_first_name": "DALE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "912-367-9841",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": "GA",
            "license": "68488",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Appling Surgical",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• The Baxley & Appling County Hospital Authority
• The Baxley and Appling County Hospital Authority
• The Baxley and Appling County Hospital Authority
• The Baxley and Appling County Hospital Authority
• The Baxley and Appling County Hospital Authority
• The Baxley and Appling County Hospital Authority
• The Baxley and Appling County Hospital Authority
• The Baxley and Appling County Hospital Authority
• The Baxley and Appling County Hospital Authority
• The Baxley and Appling County Hospital Authority

• All providers in Baxley, GA
• Surgery Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2012; 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.