NPIMap

Organization Active NPI

Hospital Authority of Valdosta and Lowndes County, Georgia

Doing business as SGMC Berrien Family Medicine

  • Clinic/Center
  • Nashville, GA
National Provider Identifier
1447591649
Registry record updated Sep 28, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
010691 Issued in GA
Legal business name
HOSPITAL AUTHORITY OF VALDOSTA AND LOWNDES COUNTY, GEORGIA
Doing business as
SGMC Berrien Family Medicine
Practice address
603 E Dennis Ave
Nashville, GA 31639-2510
Phone
(229) 686-2096
Fax
(229) 686-2104
NPI assigned
Mar 13, 2013
Last updated
Sep 28, 2017By the provider in NPPES
Organization subpart
Yes
Parent organization
HOSPITAL AUTHORITY OF VALDOSTA AND LOWNDES COUNTY, GEORGIAAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 28, 2017

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

Authorized official

Name
Mrs. Julie Hodges
Title
Controller
Phone
(229) 259-4140

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X 010691 GA Primary

Addresses

Primary practice location

603 E Dennis Ave
Nashville, GA 31639-2510

Mailing address

PO Box 0070
Valdosta, GA 31603-0070
Phone (229) 686-2096

Other names 1

  • SGMC Berrien Family Medicine Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040405001313 GA Part B Supplier - Clinic/Group Practice 1355334509 Receives reassigned benefits from 114 practitioners
13 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Valdosta, GA; Nashville, GA; Lakeland, GA

Other NPIs on the same Medicare enrollment 13

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 13

National Provider Directory

National Provider Directory
Part of
Southe Georgia Medical

Practitioners & affiliated clinicians

Practitioners 3

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": "1363132800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1506556800000",
    "number": "1447591649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 0070",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316030070",
            "telephone_number": "229-686-2096",
            "fax_number": "229-686-2104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "603 E DENNIS AVE",
            "city": "NASHVILLE",
            "state": "GA",
            "postal_code": "316392510",
            "telephone_number": "229-686-2096",
            "fax_number": "229-686-2104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOSPITAL AUTHORITY OF VALDOSTA AND LOWNDES COUNTY, GEORGIA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "HOSPITAL AUTHORITY OF VALDOSTA AND LOWNDES COUNTY, GEORGIA",
        "enumeration_date": "2013-03-13",
        "last_updated": "2017-09-28",
        "status": "A",
        "authorized_official_last_name": "HODGES",
        "authorized_official_first_name": "JULIE",
        "authorized_official_title_or_position": "CONTROLLER",
        "authorized_official_telephone_number": "229-259-4140",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "GA",
            "license": "010691",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SGMC Berrien Family Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Nashville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2017; 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.