Board of Health White County

Primary specialty

Public Health or Welfare AgencyTaxonomy code 251K00000X

Legal business name

BOARD OF HEALTH WHITE COUNTY

Practice address

1331 Helen Hwy
Cleveland, GA 30528-2834

Phone

(706) 865-2191

Fax

(706) 865-7745

NPI assigned

Jan 18, 2007

Organization subpart

No

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

Authorized official

Name

Stacy T Pollard

Title

Office Manager

Phone

(706) 865-2191

Specialties & licenses 1

Addresses

Other identifiers 7

Other names 1

• White County Health Department Other name

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

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

{
    "created_epoch": "1169078400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1497807366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1331 HELEN HWY",
            "city": "CLEVELAND",
            "state": "GA",
            "postal_code": "305282834",
            "telephone_number": "706-865-2191",
            "fax_number": "706-865-7745"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1331 HELEN HWY",
            "city": "CLEVELAND",
            "state": "GA",
            "postal_code": "305282834",
            "telephone_number": "706-865-2191",
            "fax_number": "706-865-7745"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOARD OF HEALTH WHITE COUNTY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-18",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "POLLARD",
        "authorized_official_first_name": "STACY",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "706-865-2191"
    },
    "taxonomies": [
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": "GA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000924679B",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000051972N",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000058638A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000442945O",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000456442A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10044067",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "342691",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "White County Health Department",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Emily Nonnemaker Brackett, MS, OTR/L
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• All providers in Cleveland, GA
• Public Health or Welfare Agency in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.