Organization Active NPI

Hospital Authority of Randolph County

Doing business as Randolph Medical Associates

  • Rural Health Clinic/Center
  • Cuthbert, GA
National Provider Identifier
1396749149
Registry record updated Mar 1, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
HOSPITAL AUTHORITY OF RANDOLPH COUNTY
Doing business as
Randolph Medical Associates
Practice address
125 McDonald Ave
Cuthbert, GA 39840-5829
Phone
(229) 732-3721
Fax
(229) 732-6528
NPI assigned
Jun 9, 2005
Last updated
Mar 1, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2016

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

Authorized official

Name
Kim Gilman
Title
Ceo
Phone
(229) 732-2181

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X NU Primary

Addresses

Primary practice location

125 McDonald Ave
Cuthbert, GA 39840-5829

Mailing address

361 Randolph St
Cuthbert, GA 39840-6127
Phone (229) 732-3721

Other identifiers 1

IdentifierTypeStateIssuer
00001427CMedicaidGA

Other names 1

  • Randolph Medical Associates Doing business as

National Provider Directory

National Provider Directory

Locations

125 McDonald Ave
Cuthbert, GA 39840
Phone (229) 732-3721

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1118275200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1456790400000",
    "number": "1396749149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "361 RANDOLPH ST",
            "city": "CUTHBERT",
            "state": "GA",
            "postal_code": "398406127",
            "telephone_number": "229-732-3721",
            "fax_number": "229-732-6528"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 MCDONALD AVE",
            "city": "CUTHBERT",
            "state": "GA",
            "postal_code": "398405829",
            "telephone_number": "229-732-3721",
            "fax_number": "229-732-6528"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOSPITAL AUTHORITY OF RANDOLPH COUNTY",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-09",
        "last_updated": "2016-03-01",
        "status": "A",
        "authorized_official_last_name": "GILMAN",
        "authorized_official_first_name": "KIM",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "229-732-2181"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00001427C",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Randolph Medical Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Cuthbert, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.