NPIMap

Organization Active NPI

Sumter Regional Hospital

  • Rural Health Clinic/Center
  • Ellaville, GA
National Provider Identifier
1477647824
Registry record updated Feb 26, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
SUMTER REGIONAL HOSPITAL
Doing business as
Ellaville Primary Medicine Center
Practice address
72 S Broad St
Ellaville, GA 31806
Phone
(229) 937-5321
Fax
(229) 937-2232
NPI assigned
Oct 2, 2006
Organization subpart
Yes
Parent organization
SUMTER REGIONAL HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 26, 2008

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

Authorized official

Name
Troy David Hammett
Title
VP Finance Cfo
Phone
(229) 931-1280

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X GA Primary

Addresses

Primary practice location

72 S Broad St
Ellaville, GA 31806

Mailing address

PO Box 65
Americus, GA 31719
Phone (229) 924-6011

Other identifiers 1

IdentifierTypeStateIssuer
00000019FMedicaidGA

Other names 1

  • Ellaville Primary Medicine Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Sumter Regional Hosp4 organizations share this tax ID, including this one
Part of
Sumter Regional Hosp

Other organizations with this tax ID 3

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

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1203984000000",
    "number": "1477647824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 65",
            "city": "AMERICUS",
            "state": "GA",
            "postal_code": "31719",
            "telephone_number": "229-924-6011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "72 S BROAD ST",
            "city": "ELLAVILLE",
            "state": "GA",
            "postal_code": "31806",
            "telephone_number": "229-937-5321",
            "fax_number": "229-937-2232"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUMTER REGIONAL HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SUMTER REGIONAL HOSPITAL",
        "enumeration_date": "2006-10-02",
        "last_updated": "2008-02-26",
        "status": "A",
        "authorized_official_last_name": "HAMMETT",
        "authorized_official_first_name": "TROY",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "VP FINANCE CFO",
        "authorized_official_telephone_number": "229-931-1280"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "GA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00000019F",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ellaville Primary Medicine Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Ellaville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.