Active NPI
Crisp County Board of Health
- Public Health or Welfare Agency
- Cordele, GA
National Provider Identifier
1427093285
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Public Health or Welfare Agency
- 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, 2025
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Beverley Townsend, M.D.
- 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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00058726E | Medicaid | GA | |
| 000457729F | Medicaid | GA | |
| 00052082D | Medicaid | GA | |
| 000453164O | Medicaid | GA | |
| 00647226A | Medicaid | GA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20111129000462 | GA | Part B Supplier - Mass Immunization (Roster Biller Only) | 6204000334 | Practice locations: Cordele, GA |
National Provider Directory
National Provider DirectoryLocations
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.
-
- Family Medicine Physician
- Columbus, GA
- NPI 1497846133
-
- Women's Health Nurse Practitioner
- Cordele, GA
- NPI 1871637413
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.