Organization Active NPI

Crisp County Board of Health

  • Public Health or Welfare Agency
  • Cordele, GA
National Provider Identifier
1427093285
Registry record updated Sep 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Public Health or Welfare AgencyTaxonomy code 251K00000X
Legal business name
CRISP COUNTY BOARD OF HEALTH
Practice address
111 E 24TH Ave
Cordele, GA 31015-3834
Phone
(833) 337-1749
Fax
(706) 321-6126
NPI assigned
Jun 17, 2006
Last updated
Sep 29, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2025

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

Authorized official

Name
Beverley Townsend, M.D.NPI 1497846133
Title
Health Director
Phone
(706) 321-6108

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Public Health or Welfare Agency 251K00000X Primary

Addresses

Primary practice location

111 E 24TH Ave
Cordele, GA 31015-3834

Mailing address

111 E 24TH Ave
Cordele, GA 31015-3834
Phone (833) 337-1749

Other identifiers 5

IdentifierTypeStateIssuer
00058726EMedicaidGA
000457729FMedicaidGA
00052082DMedicaidGA
000453164OMedicaidGA
00647226AMedicaidGA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20111129000462 GA Part B Supplier - Mass Immunization (Roster Biller Only) 6204000334 Practice locations: Cordele, GA

National Provider Directory

National Provider Directory

Locations

111 E 24th Ave
Cordele, GA 31015
Phone (229) 246-2680

Practitioners & affiliated clinicians

Practitioners 2

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": "1150502400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1759104000000",
    "number": "1427093285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 E 24TH AVE",
            "city": "CORDELE",
            "state": "GA",
            "postal_code": "310153834",
            "telephone_number": "833-337-1749",
            "fax_number": "706-321-6126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 E 24TH AVE",
            "city": "CORDELE",
            "state": "GA",
            "postal_code": "310153834",
            "telephone_number": "833-337-1749",
            "fax_number": "706-321-6126"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRISP COUNTY BOARD OF HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-17",
        "last_updated": "2025-09-29",
        "certification_date": "2025-09-29",
        "status": "A",
        "authorized_official_last_name": "TOWNSEND",
        "authorized_official_first_name": "BEVERLEY",
        "authorized_official_title_or_position": "HEALTH DIRECTOR",
        "authorized_official_telephone_number": "706-321-6108",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00058726E",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000457729F",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00052082D",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000453164O",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00647226A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cordele, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2025; 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.