Neighborhood Improvement Project Inc
Organization Active NPI Federally Qualified Health Center (FQHC) · Augusta, GA
NPI 1548757024 · NPPES record last updated Apr 19, 2018
Key facts
- NPI
- 1548757024
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Federally Qualified Health Center (FQHC) 261QF0400X
- Legal business name
- NEIGHBORHOOD IMPROVEMENT PROJECT INC
- Practice address
- 1111 Garredd Blvd Ste a
Augusta, GA 30909-6674 - Phone
- (706) 863-5776
- NPI assigned
- Apr 19, 2018
- Organization subpart
- No
Authorized official
- Name
- Wesley Wood
- Title
- Cfo
- Phone
- (706) 790-4440
Owned or controlled facilities with NPI records 9
Other NPIs with the same Medicare PAC ID 24
Corporate family (same tax ID) 33
Practitioners 68
-
Jose H Acevedo, M.D.
-
Evan C Bahr, MD
-
Tara Roychell Blair, APRN
-
Veronica Bradford, APRN
-
Samuel Edward Burkett, M.D.
-
Raisa Mary Colon, NP
-
Kepler Austin Davis, M.D.
-
Alan Joseph Deangelo, M.D.
-
Ketki Desai, MD
-
Mallika Devarapalli, D.O.
-
Alice Kimberly Duffey, FNP-BC
-
Silvia Heidi Dunn, FNP-C
-
Leyla El-Choufi, M.D.
-
Bie Mende Etinge, DO
-
James Milton Ford, M.D.
-
Carlos Foster, LCSW
-
Jones Mark Gresham, M.D.
-
George S Havrilla, DPM
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 11D0711803 | Medical Associates Plus | Certificate of waiver | Jan 29, 2027 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
Federally qualified health center certification: CCN 111093
- Legal name
- NEIGHBORHOOD IMPROVEMENT PROJECT, INC
- Certification status
- Active
- Provider type (POS)
- Federally qualified health center
- Participating since
- Jul 26, 2018
- Last certification
- Jul 26, 2018
- Ownership / control type
- For profit – corporation
- Organization structure
- Corporation · Non-profit
- Enrollment address
- 1111 Garredd Blvd
Augusta, GA 30909-6649
All disclosed owners & managing parties 10
| Name | Role | Since | Share |
|---|---|---|---|
| Melvin Lowry |
Other | Dec 5, 2007 | |
| Janice Bailey |
Corporate Officer | Dec 5, 2007 | |
| Willie Saunders |
Corporate Officer | Jan 1, 2016 | |
| Kim Gaines |
Other | Dec 5, 2007 | |
| James Williams |
Corporate Officer | Feb 29, 2008 | |
| Wesley Wood |
5% Or Greater Direct Ownership Interest | May 1, 2017 | 100% |
| Corporate Officer |
May 8, 2017 | ||
| W-2 Managing Employee | May 8, 2017 | 100% | |
| Francine Holmes |
Corporate Officer | Jan 1, 2012 | |
| Nancy Ross |
Corporate Officer | Dec 5, 2007 | |
| Willie Jones |
Corporate Officer | Jan 1, 2016 | |
| Barbara Washington |
Corporate Officer | Jan 1, 2016 |
All facility ownership & control disclosures 9
| Facility | Type | Role | Since |
|---|---|---|---|
| Medical Associates Plus at Wrens |
Federally qualified health center | Operational/Managerial Control | Dec 1, 2013 |
| Neighborhood Improvement Project, Inc |
Federally qualified health center | 5% Or Greater Direct Ownership Interest (100%) | Jan 1, 2016 |
| Medical Associates Plus |
Federally qualified health center | Operational/Managerial Control | Jan 1, 2016 |
| Neighborhood Improvement Project, Inc |
Federally qualified health center | Operational/Managerial Control | Jan 7, 2022 |
| Medical Associates Plus |
Federally qualified health center | Operational/Managerial Control (100%) | Apr 1, 2022 |
| Medical Associates Plus |
Federally qualified health center | Operational/Managerial Control | Jul 1, 2022 |
| Medical Associates Plus |
Federally qualified health center | Operational/Managerial Control | Oct 1, 2022 |
| Medical Associates Plus |
Federally qualified health center | Operational/Managerial Control | Jan 1, 2023 |
| Medical Associates Plus |
Federally qualified health center | Other | Dec 1, 2024 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20180726001319 | GA | Part a Provider - Federally Qualified Health Center (FQHC) | 7315851078 | Practice locations: Augusta, GA |
National Provider Directory
- Tax ID family
- Neighborhood Improvement Project
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Federally Qualified Health Center (FQHC) | 261QF0400X | Yes |
Addresses
Primary practice location
1111 Garredd Blvd Ste a
Augusta, GA 30909-6674
Mailing address
2467 Golden Camp Rd
Augusta, GA 30906-5515
Phone (866) 770-4104
Other names
- Medical Associates Plus
Other providers in Augusta, GA
- Neighborhood Improvement Project Inc
- Neighborhood Improvement Project Inc
- Neighborhood Improvement Project Inc
- Neighborhood Improvement Project Inc
- Neighborhood Improvement Project Inc
- Neighborhood Improvement Project Inc
- Neighborhood Improvement Project Inc
- Neighborhood Improvement Project Inc
- Neighborhood Improvement Project Inc
- Neighborhood Improvement Project Inc
All providers in Augusta, GA · Federally Qualified Health Center (FQHC) in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 19, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.