NPIMap

Organization Active NPI

Lookout Mountain Community Services

  • Community/Behavioral Health Agency
  • Lafayette, GA
National Provider Identifier
1386716124
Registry record updated Feb 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
LOOKOUT MOUNTAIN COMMUNITY SERVICES
Practice address
501 Mize St.
Lafayette, GA 30728
Phone
(706) 638-5591
Fax
(706) 639-2055
NPI assigned
Nov 15, 2006
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Alicia Michelle Howard
Title
Credentialing
Phone
(706) 670-1080

Other NPIs on the same Medicare enrollment 5

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

Corporate family (same tax ID) 24

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

View all 24

Practitioners 31

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

View all 31

Medicare participation

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

Medicare enrollment records 1

Medicare enrollment files
Enrollment IDStateProvider typePAC IDDetails
O20040506000251 GA Part B Supplier - Clinic/Group Practice 4880682822 Receives reassigned benefits from 28 practitioners
5 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: La Fayette, GA; Ft. Oglethorpe, GA; Trenton, GA; Summerville, GA

National Provider Directory

National Provider Directory
Tax ID family
Lookout Mountain Community Services (107 organizations share this tax ID)

Locations

110 Hedekin Cir
Ft Oglethorpe, GA 30742
Phone (706) 866-5945

83 Highway 48
Summerville, GA 30747
Phone (706) 857-5441

Specialties & licenses 1

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

Addresses

NPPES NPI Registry

Primary practice location

501 Mize St.
Lafayette, GA 30728

Mailing address

PO Box 1027
La Fayette, GA 30728-1027
Phone (706) 638-5584

Other identifiers 1

NPPES NPI Registry
IdentifierTypeStateIssuer
00604513B-22MedicaidGA

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Feb 10, 2023.

{
    "created_epoch": "1163548800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1675987200000",
    "number": "1386716124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1027",
            "city": "LA FAYETTE",
            "state": "GA",
            "postal_code": "307281027",
            "telephone_number": "706-638-5584",
            "fax_number": "706-638-5585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 MIZE ST.",
            "city": "LAFAYETTE",
            "state": "GA",
            "postal_code": "30728",
            "telephone_number": "706-638-5591",
            "fax_number": "706-639-2055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOOKOUT MOUNTAIN COMMUNITY SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-15",
        "last_updated": "2023-02-10",
        "certification_date": "2023-02-10",
        "status": "A",
        "authorized_official_last_name": "HOWARD",
        "authorized_official_first_name": "ALICIA",
        "authorized_official_middle_name": "MICHELLE",
        "authorized_official_title_or_position": "CREDENTIALING",
        "authorized_official_telephone_number": "706-670-1080"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00604513B-22",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lafayette, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2023; 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.