NPIMap

Organization Active NPI

Sumter Regional Hospital

  • Rural Health Clinic/Center
  • Ellaville, GA
National Provider Identifier
1487719076
Registry record updated Aug 22, 2020
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
Dec 26, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Ms. Maryanne Shepherd, N. P.
Title
Director
Phone
(229) 937-5321

Specialties & licenses 1

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

Addresses

Primary practice location

72 S. Broad St.
Ellaville, GA 31806

Mailing address

PO Box 65
Ellaville, GA 31806-0065
Phone (229) 937-5321

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

Other organizations with this tax ID 3

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

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1167091200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1487719076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 65",
            "city": "ELLAVILLE",
            "state": "GA",
            "postal_code": "318060065",
            "telephone_number": "229-937-5321",
            "fax_number": "229-937-2232"
        },
        {
            "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": "NO",
        "enumeration_date": "2006-12-26",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SHEPHERD",
        "authorized_official_first_name": "MARYANNE",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "229-937-5321",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "N. P."
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "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 Aug 22, 2020; 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.