Bacchus Operations Group, Inc.

Primary specialty

Rural Health Clinic/CenterTaxonomy code 261QR1300X

License

094-391 Issued in GA

Legal business name

BACCHUS OPERATIONS GROUP, INC.

Doing business as

Flint River Rural Health Clinic - Ellaville

Practice address

509 Sumter Street
Montezuma, GA 31063-1733

Phone

(478) 472-3100

Fax

(478) 472-2412

NPI assigned

Dec 8, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Philip H Eastman III

Title

Chief Executive Officer

Phone

(478) 472-3100

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Flint River Rural Health Clinic - Ellaville Doing business as

Locations

Practitioners 1

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

• Douglas Ray Joyner, MD

  • Surgery Physician
  • Montezuma, GA
  • NPI 1285726182
  NPD (past)

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

{
    "created_epoch": "1165536000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1332460800000",
    "number": "1518026202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "509 SUMTER STREET",
            "address_2": "PO BOX 770",
            "city": "MONTEZUMA",
            "state": "GA",
            "postal_code": "310631733",
            "telephone_number": "478-472-3100",
            "fax_number": "478-472-2412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "509 SUMTER STREET",
            "city": "MONTEZUMA",
            "state": "GA",
            "postal_code": "310631733",
            "telephone_number": "478-472-3100",
            "fax_number": "478-472-2412"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BACCHUS OPERATIONS GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-08",
        "last_updated": "2012-03-23",
        "status": "A",
        "authorized_official_last_name": "EASTMAN",
        "authorized_official_first_name": "PHILIP",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "478-472-3100",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "III"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "GA",
            "license": "094-391",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000149487B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Flint River Rural Health Clinic - Ellaville",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Bacchus Operations Group, Inc
• Bacchus Operations Group, Inc
• Bacchus Operations Group, Inc.
• Bacchus Operations Group, Inc.
• Bacchus Operations Group, Inc.
• Bridget April Barrow, NP
• Lucille Brown
• Careconnect Health, Inc.
• Coordination Services of Atlanta Inc.

• Rural Health Clinic/Center in Montezuma, GA
• Providers in Montezuma, GA by specialty
• Rural Health Clinic/Center in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2012; 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.