NPIMap

Organization Active NPI

Fci Jesup

  • Prison Health Clinic/Center
  • Jesup, GA
National Provider Identifier
1508538679
Registry record updated Sep 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prison Health Clinic/CenterTaxonomy code 261QP2400X
Legal business name
FCI JESUP
Practice address
2600 Highway 301 South
Jesup, GA 31599-0001
Phone
(912) 427-0870
NPI assigned
Sep 28, 2021
Last updated
Sep 28, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
FEDERAL BUREAU OF PRISONSAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 28, 2021

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

Authorized official

Name
Dr. Patrick Tully
Title
Chief Pharmacist
Phone
(912) 427-0870

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Prison Health Clinic/Center 261QP2400X Primary
Clinic Pharmacy 3336C0002X

Addresses

Primary practice location

2600 Highway 301 South
Jesup, GA 31599-0001

Mailing address

2600 Highway 301 South
Jesup, GA 31599-0001
Phone (912) 427-0870

National Provider Directory

National Provider Directory
Tax ID family
Federal Bureau of Prisonsfci Loretto49 organizations share this tax ID, including this one
Part of
Federal Bureau of Prisonsfci Loretto

Other organizations with this tax ID 48

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

View all 48

Locations

2600 S US Highway 301
Jesup, GA 31599
Phone (912) 427-0870

Practitioners & affiliated clinicians

Practitioners 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1632787200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1632787200000",
    "number": "1508538679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2600 HIGHWAY 301 SOUTH",
            "city": "JESUP",
            "state": "GA",
            "postal_code": "315990001",
            "telephone_number": "912-427-0870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 HIGHWAY 301 SOUTH",
            "city": "JESUP",
            "state": "GA",
            "postal_code": "315990001",
            "telephone_number": "912-427-0870"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FCI JESUP",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FEDERAL BUREAU OF PRISONS",
        "enumeration_date": "2021-09-28",
        "last_updated": "2021-09-28",
        "certification_date": "2021-09-28",
        "status": "A",
        "authorized_official_last_name": "TULLY",
        "authorized_official_first_name": "PATRICK",
        "authorized_official_title_or_position": "CHIEF PHARMACIST",
        "authorized_official_telephone_number": "912-427-0870",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "261QP2400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Prison Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "3336C0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Clinic Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jesup, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2021; 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.