NPIMap

Organization Active NPI

Jenkins County Hospital LLC

Doing business as Optim Medical Center - Jenkins

  • Critical Access Hospital
  • Millen, GA
National Provider Identifier
1497064679
Registry record updated Jul 24, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Access HospitalTaxonomy code 282NC0060X
License
082-270 Issued in GA
Legal business name
JENKINS COUNTY HOSPITAL LLC
Doing business as
Optim Medical Center - Jenkins
Practice address
931 E Winthrope Ave
Millen, GA 30442-1839
Phone
(478) 982-4221
Fax
(478) 982-2478
NPI assigned
Oct 5, 2010
Last updated
Jul 24, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2015

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

Authorized official

Name
Mr. Robert Guenthner
Title
Secretary of Jenkins County Hospita
Phone
(312) 627-8247

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Access Hospital 282NC0060X 082-270 GA Primary

Addresses

Primary practice location

931 E Winthrope Ave
Millen, GA 30442-1839

Mailing address

210 E Derenne Ave
Savannah, GA 31405-6736
Phone (912) 644-5300

Other names 1

  • Optim Medical Center - Jenkins Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110126000836 GA Part B Supplier - Clinic/Group Practice 0143419820 Receives reassigned benefits from 5 practitioners
10 other NPIs on this enrollment
Practice locations: Millen, GA

Other NPIs on the same Medicare enrollment 10

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

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 39

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.

View all 39

NPI Registry JSON

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

{
    "created_epoch": "1286236800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1437696000000",
    "number": "1497064679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 E DERENNE AVE",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314056736",
            "telephone_number": "912-644-5300",
            "fax_number": "912-644-5260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "931 E WINTHROPE AVE",
            "city": "MILLEN",
            "state": "GA",
            "postal_code": "304421839",
            "telephone_number": "478-982-4221",
            "fax_number": "478-982-2478"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JENKINS COUNTY HOSPITAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-05",
        "last_updated": "2015-07-24",
        "status": "A",
        "authorized_official_last_name": "GUENTHNER",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "SECRETARY OF JENKINS COUNTY HOSPITA",
        "authorized_official_telephone_number": "312-627-8247",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": "GA",
            "license": "082-270",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Optim Medical Center - Jenkins",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Millen, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2015; 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.