NPIMap

Organization Active NPI

Lookout Mountain Community Services

  • Community/Behavioral Health Agency
  • Fort Oglethorpe, GA
National Provider Identifier
1568599090
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
LOOKOUT MOUNTAIN COMMUNITY SERVICES
Practice address
700 City Hall Dr
Ft Oglethorpe, GA 30742-7802
Phone
(706) 638-5580
NPI assigned
Feb 28, 2007
Last updated
Jul 21, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Deborah Farris
Title
Billing and Ar Manager
Phone
(706) 638-5580

Specialties & licenses 1

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

Addresses

Primary practice location

700 City Hall Dr
Ft Oglethorpe, GA 30742-7802

Mailing address

PO Box 1027
Lafayette, GA 30728
Phone (706) 638-5580

Other identifiers 1

IdentifierTypeStateIssuer
000604513C-23MedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040506000251 GA Part B Supplier - Clinic/Group Practice 4880682822 Receives reassigned benefits from 28 practitioners
5 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: La Fayette, GA; Ft. Oglethorpe, GA; Trenton, GA; Summerville, GA

Other NPIs on the same Medicare enrollment 5

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

700 City Hall Dr
Ft Oglethorpe, GA 30742
Phone (706) 638-5584

12586 N Main St
Trenton, GA 30752
Phone (706) 956-5526

Practitioners & affiliated clinicians

Practitioners 28

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.

View all 28

NPI Registry JSON

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

{
    "created_epoch": "1172620800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1568599090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1027",
            "city": "LAFAYETTE",
            "state": "GA",
            "postal_code": "30728",
            "telephone_number": "706-638-5580",
            "fax_number": "706-638-6855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 CITY HALL DR",
            "city": "FT OGLETHORPE",
            "state": "GA",
            "postal_code": "307427802",
            "telephone_number": "706-638-5580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOOKOUT MOUNTAIN COMMUNITY SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-28",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "FARRIS",
        "authorized_official_first_name": "DEBORAH",
        "authorized_official_title_or_position": "BILLING AND AR MANAGER",
        "authorized_official_telephone_number": "706-638-5580"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "GA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000604513C-23",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Oglethorpe, GA

Sources for this page

  • 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.