NPIMap

Organization Active NPI

Bowdon-Mt Zion Primary Health Center Inc.

Doing business as MtZion Primary Healthcare Clinic

  • Family Medicine Physician
  • Carrollton, GA
National Provider Identifier
1417428772
Registry record updated Mar 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
BOWDON-MT ZION PRIMARY HEALTH CENTER INC.
Doing business as
MtZion Primary Healthcare Clinic
Practice address
4248 Mount Zion Rd
Carrollton, GA 30117-7602
Phone
(770) 836-0103
Fax
(770) 834-8828
NPI assigned
Dec 16, 2018
Organization subpart
Yes
Parent organization
BOWDON-MT ZION PRIMARY HEALTH CENTER INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 18, 2022

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

Authorized official

Name
Christy Brewer
Title
Office Manager
Phone
(706) 675-8669

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

4248 Mount Zion Rd
Carrollton, GA 30117-7602

Mailing address

PO Box 658
Mount Zion, GA 30150-0658
Phone (770) 836-0103

Other names 1

  • MtZion Primary Healthcare Clinic Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Franklin Primary Health5 organizations share this tax ID, including this one
Part of
Franklin Primary Health

Other organizations with this tax ID 4

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

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": "1544918400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1647561600000",
    "number": "1417428772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 658",
            "city": "MOUNT ZION",
            "state": "GA",
            "postal_code": "301500658",
            "telephone_number": "770-836-0103",
            "fax_number": "770-834-8828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4248 MOUNT ZION RD",
            "city": "CARROLLTON",
            "state": "GA",
            "postal_code": "301177602",
            "telephone_number": "770-836-0103",
            "fax_number": "770-834-8828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOWDON-MT ZION PRIMARY HEALTH CENTER INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BOWDON-MT ZION PRIMARY HEALTH  CENTER INC.",
        "enumeration_date": "2018-12-16",
        "last_updated": "2022-03-18",
        "certification_date": "2022-03-18",
        "status": "A",
        "authorized_official_last_name": "BREWER",
        "authorized_official_first_name": "CHRISTY",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "706-675-8669"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MtZion Primary Healthcare Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "MtZion Primary Healthcare Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Carrollton, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2022; 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.