NPIMap

Organization Active NPI

Palmetto Health Council Inc

Doing business as YourTown Health

  • Federally Qualified Health Center (FQHC)
  • Carrollton, GA
National Provider Identifier
1467612952
Registry record updated May 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
License
H800040 Issued in GA
Legal business name
PALMETTO HEALTH COUNCIL INC
Doing business as
YourTown Health
Practice address
202 Croft St
Carrollton, GA 30117-3803
Phone
(770) 834-2255
Fax
(770) 834-7100
NPI assigned
Jun 10, 2008
Last updated
May 14, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 14, 2025

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

Authorized official

Name
Dr. Tara L Brown, DMD
Title
Ceo
Phone
(404) 929-8824

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X H800040 GA Primary
Family Medicine Physician 207Q00000X H800040 GA

Addresses

Primary practice location

202 Croft St
Carrollton, GA 30117-3803

Mailing address

643 Main St
Palmetto, GA 30268-1138
Phone (404) 929-8824

Other identifiers 1

IdentifierTypeStateIssuer
000472128GMedicaidGA

Other names 1

  • YourTown Health Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080214000012 GA Part A Provider - Federally Qualified Health Center (FQHC) 3476586629 1 other NPI on this enrollment
Practice locations: Carrollton, GA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1467612952. Details of each certification follow.

Federally qualified health center certification: CCN 111903

Legal name
PALMETTO HEALTH COUNCIL INC
Doing business as
COMMUNITY MEDICAL CENTER
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Feb 14, 2008
Last certification
Feb 14, 2008
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Jun 1, 1978 in GA
Enrollment address
202 Croft St
Carrollton, GA 30117-3803

Other NPIs with the same Medicare PAC ID 6

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 1

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

National Provider Directory

National Provider Directory
Tax ID family
Palmetto Health Council Inc6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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

Ownership & related parties

All disclosed owners & managing parties 9

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Thomas Morrow Individual Corporate Director Jan 2, 2008
Tara L Brown Individual Corporate OfficerCeo Dec 20, 2020
W-2 Managing Employee Dec 20, 2020
Loretta M North Individual Corporate Director Oct 1, 2011
Valerie Sutton Individual Corporate Director Aug 31, 2021
Patsy S Page Individual Corporate Director Oct 1, 2010
Pat Ackey Individual Corporate Director Oct 14, 2017
Calvin C Ruffin Individual Corporate Director Oct 1, 2011
Carlos Montano Individual Corporate Director Jul 31, 2018
Eugene Smenner Individual Corporate Director Oct 1, 2009

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Community Medical CenterWarm Springs, GA, CCN 111923 Federally qualified health center Operational/Managerial Control Nov 29, 2004

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1213056000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1747180800000",
    "number": "1467612952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "643 MAIN ST",
            "city": "PALMETTO",
            "state": "GA",
            "postal_code": "302681138",
            "telephone_number": "404-929-8824",
            "fax_number": "404-929-9769"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "202 CROFT ST",
            "city": "CARROLLTON",
            "state": "GA",
            "postal_code": "301173803",
            "telephone_number": "770-834-2255",
            "fax_number": "770-834-7100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PALMETTO HEALTH COUNCIL INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-10",
        "last_updated": "2025-05-14",
        "certification_date": "2025-05-14",
        "status": "A",
        "authorized_official_last_name": "BROWN",
        "authorized_official_first_name": "TARA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "404-929-8824",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "GA",
            "license": "H800040",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "H800040",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000472128G",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "YourTown Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Carrollton, GA

Sources for this page

Verify at the official NPI Registry.