NPIMap

Organization Active NPI

Hospital Authority of Candler County

Doing business as Candler Surgical and Family Medicine

  • Surgery Physician
  • Metter, GA
National Provider Identifier
1598056988
Registry record updated Oct 24, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
HOSPITAL AUTHORITY OF CANDLER COUNTY
Doing business as
Candler Surgical and Family Medicine
Practice address
415 Cedar St
Metter, GA 30439-3339
Phone
(912) 685-1251
Fax
(912) 685-1254
NPI assigned
Apr 20, 2011
Last updated
Oct 24, 2013By the provider in NPPES
Organization subpart
Yes
Parent organization
HOSPITAL AUTHORITY OF CANDLER COUNTYAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 24, 2013

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

Authorized official

Name
Stephen Shepherd
Title
Fache
Phone
(912) 685-5741

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU
Surgery Physician 208600000X NU Primary

Addresses

Primary practice location

415 Cedar St
Metter, GA 30439-3339

Mailing address

PO Box 597
Metter, GA 30439-0597
Phone (912) 826-4057

Other names 1

  • Candler Surgical and Family Medicine Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040305000415 GA Part B Supplier - Clinic/Group Practice 5294623948 Receives reassigned benefits from 53 practitioners
4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Metter, GA; Pulaski, GA

Other NPIs on the same Medicare enrollment 4

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

National Provider Directory

National Provider Directory
Tax ID family
Hosp Auth Candler Co8 organizations share this tax ID, including this one
Part of
Hosp Auth Candler Co

Other organizations with this tax ID 7

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

Practitioners & affiliated clinicians

Practitioners 7

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": "1303257600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1382572800000",
    "number": "1598056988",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 597",
            "city": "METTER",
            "state": "GA",
            "postal_code": "304390597",
            "telephone_number": "912-826-4057"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 CEDAR ST",
            "city": "METTER",
            "state": "GA",
            "postal_code": "304393339",
            "telephone_number": "912-685-1251",
            "fax_number": "912-685-1254"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOSPITAL AUTHORITY OF CANDLER COUNTY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "HOSPITAL AUTHORITY OF CANDLER COUNTY",
        "enumeration_date": "2011-04-20",
        "last_updated": "2013-10-24",
        "status": "A",
        "authorized_official_last_name": "SHEPHERD",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_title_or_position": "FACHE",
        "authorized_official_telephone_number": "912-685-5741"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Candler Surgical and Family Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Metter, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2013; 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.