Active NPI
Early County Health Dept
- Public Health or Welfare Agency
- Blakely, GA
National Provider Identifier
1447241591
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Public Health or Welfare Agency
- Legal business name
- EARLY COUNTY HEALTH DEPT
- Practice address
- 618 Flowers Dr
Blakely, GA 39823-2804 - Phone
- (229) 723-3707
- Fax
- (229) 723-8246
- NPI assigned
- Oct 28, 2005
- Last updated
- Jan 25, 2024
- 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
- Treisha Johnson
- Title
- District Admin
- Phone
- (229) 248-3055
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Public Health or Welfare Agency | 251K00000X | NU | Primary |
Addresses
Primary practice location
618 Flowers Dr
Blakely, GA 39823-2804
Mailing address
618 Flowers Dr
Blakely, GA 39823-2804
Phone (229) 723-3707
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00442879E | Medicaid | GA | |
| 00052049G | Medicaid | GA | |
| 00442879G | Medicaid | GA | |
| 00456475F | 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 |
|---|---|---|---|---|
| O20150424000052 | GA | Part B Supplier - Mass Immunization (Roster Biller Only) | 9032011572 | Practice locations: Blakely, GA |
National Provider Directory
National Provider DirectoryLocations
618 Flowers Dr
Blakely, GA 39823
Phone (229) 207-0049
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.
-
- Family Nurse Practitioner
- Blakely, GA
- NPI 1952015794
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1130457600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1706140800000",
"number": "1447241591",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "618 FLOWERS DR",
"city": "BLAKELY",
"state": "GA",
"postal_code": "398232804",
"telephone_number": "229-723-3707",
"fax_number": "229-723-8246"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "618 FLOWERS DR",
"city": "BLAKELY",
"state": "GA",
"postal_code": "398232804",
"telephone_number": "229-723-3707",
"fax_number": "229-723-8246"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "EARLY COUNTY HEALTH DEPT",
"organizational_subpart": "NO",
"enumeration_date": "2005-10-28",
"last_updated": "2024-01-25",
"certification_date": "2024-01-25",
"status": "A",
"authorized_official_last_name": "JOHNSON",
"authorized_official_first_name": "TREISHA",
"authorized_official_title_or_position": "DISTRICT ADMIN",
"authorized_official_telephone_number": "229-248-3055"
},
"taxonomies": [
{
"code": "251K00000X",
"taxonomy_group": "",
"desc": "Public Health or Welfare",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00442879E",
"state": "GA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00052049G",
"state": "GA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00442879G",
"state": "GA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00456475F",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Blakely, GA
- Department of Family and Children Services of Seminole County
- Dialysis Clinic Inc.
- Tawanna Drake
- Kari Suzanne Dunn, LPC
- Kevin Cordale Eaford, CPT
- Early County School System
- Early Memorial Hospital (Early Memorial Nursing Home)
- Early Memorial Hospital (Blakely Medical Group)
- Early Memorial Hospital (Early Memorial Hospital - Swingbed)
- Early Memorial Hospital (Early Memorial Hospital - EMS)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2024; 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.