NPIMap

Organization Active NPI

Community Service Board of Middle Georgia

  • Community/Behavioral Health Agency
  • Sylvania, GA
National Provider Identifier
1538680756
Registry record updated Jun 28, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
COMMUNITY SERVICE BOARD OF MIDDLE GEORGIA
Practice address
600 Lawton Rd
Sylvania, GA 30467-4547
Phone
(912) 829-4511
Fax
(478) 289-2798
NPI assigned
Jun 28, 2017
Last updated
Jun 28, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2017

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

Authorized official

Name
Keith Moran
Title
Cfo
Phone
(478) 275-6811

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X NU Primary

Addresses

Primary practice location

600 Lawton Rd
Sylvania, GA 30467-4547

Mailing address

223 N Anderson Dr
Swainsboro, GA 30401-4440
Phone (478) 289-2683

Other identifiers 1

IdentifierTypeStateIssuer
000709288WMedicaidGA

National Provider Directory

National Provider Directory
Tax ID family
Community Service Board of Middle Georgia30 organizations share this tax ID, including this one

Other organizations with this tax ID 29

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

View all 29

Practitioners & affiliated clinicians

Practitioners 1

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": "1498608000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1498608000000",
    "number": "1538680756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "223 N ANDERSON DR",
            "city": "SWAINSBORO",
            "state": "GA",
            "postal_code": "304014440",
            "telephone_number": "478-289-2683",
            "fax_number": "478-289-2798"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 LAWTON RD",
            "city": "SYLVANIA",
            "state": "GA",
            "postal_code": "304674547",
            "telephone_number": "912-829-4511",
            "fax_number": "478-289-2798"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY SERVICE BOARD OF MIDDLE GEORGIA",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-06-28",
        "last_updated": "2017-06-28",
        "status": "A",
        "authorized_official_last_name": "MORAN",
        "authorized_official_first_name": "KEITH",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "478-275-6811"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000709288W",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sylvania, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2017; 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.