NPIMap

Organization Active NPI

Neighborhood Improvement Project Inc

  • Federally Qualified Health Center (FQHC)
  • Keysville, GA
National Provider Identifier
1609248996
Registry record updated Mar 16, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
NEIGHBORHOOD IMPROVEMENT PROJECT INC
Practice address
480 Martin Luther King Rd
Ste B
Keysville, GA 30816-4444
Phone
(706) 790-4440
NPI assigned
Oct 26, 2015
Last updated
Mar 16, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2016

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

Authorized official

Name
Wesley Wood
Title
Cfo
Phone
(706) 790-4440

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

480 Martin Luther King Rd
Ste B
Keysville, GA 30816-4444

Mailing address

2467 Golden Camp Rd
Augusta, GA 30906-5515

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160811001690 GA Part A Provider - Federally Qualified Health Center (FQHC) 7315851078 Practice locations: Keysville, GA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1609248996. Details of each certification follow.

Federally qualified health center certification: CCN 111042

Legal name
NEIGHBORHOOD IMPROVEMENT PROJECT, INC
Doing business as
MEDICAL ASSOCIATES PLUS
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Aug 11, 2016
Last certification
Aug 11, 2016
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Sep 23, 2014 in GA
Enrollment address
480 Martin Luther King Rd
Lot B
Keysville, GA 30816-4464

Other NPIs with the same Medicare PAC ID 24

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

View all 24

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
11D2109218Medical Associates Plus-Keysville480B Martin Luther King Road, Keysville, GA 30816Provider-performed microscopyFeb 21, 2028

National Provider Directory

National Provider Directory
Tax ID family
Neighborhood Improv Project34 organizations share this tax ID, including this one

Other organizations with this tax ID 33

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

View all 33

Ownership & related parties

All disclosed owners & managing parties 9

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Janice Bailey Individual Corporate OfficerBoard Member Dec 5, 2007
Willie Saunders Individual Corporate OfficerBoard Member Jan 1, 2016
Neighborhood Improvement Project, Inc Organization, Augusta, GA Non-profit Operational/Managerial Control Jan 1, 2016
James Williams Individual Corporate OfficerBoard Member Feb 29, 2008
Wesley Wood Individual Corporate Officer Jan 1, 2015
Operational/Managerial ControlCfo Jan 1, 2015
Francine Holmes Individual Corporate OfficerBoard Member Jan 1, 2012
Nancy Ross Individual Corporate OfficerBoard Member Dec 5, 2007
Willie Jones Individual Corporate OfficerBoard Member Jan 1, 2016
Barbara Washington Individual Corporate OfficerBoard Member Jan 1, 2016

Owners & managing parties with NPI records 24

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

View all 24

All facility ownership & control disclosures 8

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Medical Associates Plus at WrensWrens, GA, CCN 111976 Federally qualified health center Operational/Managerial Control Dec 1, 2013
Neighborhood Improvement Project, IncAugusta, GA, CCN 111038 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Jan 1, 2016
Neighborhood Improvement Project, IncWaynesboro, GA, CCN 851162 Federally qualified health center Operational/Managerial Control Jan 7, 2022
Medical Associates PlusAugusta, GA, CCN 851169 Federally qualified health center Operational/Managerial Control (100%) Apr 1, 2022
Medical Associates PlusWaynesboro, GA, CCN 851175 Federally qualified health center Operational/Managerial Control Jul 1, 2022
Medical Associates PlusAugusta, GA, CCN 851176 Federally qualified health center Operational/Managerial Control Oct 1, 2022
Medical Associates PlusThomson, GA, CCN 111189 Federally qualified health center Operational/Managerial Control Jan 1, 2023
Medical Associates PlusAiken, SC, CCN 421121 Federally qualified health center Other Dec 1, 2024

Owned or controlled facilities with NPI records 8

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Facilities with the same owner 7

Facilities that share an organizational owner with 5% or greater ownership or operational control.

NPI Registry JSON

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

{
    "created_epoch": "1445817600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1458086400000",
    "number": "1609248996",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2467 GOLDEN CAMP RD",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309065515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "480 MARTIN LUTHER KING RD",
            "address_2": "STE B",
            "city": "KEYSVILLE",
            "state": "GA",
            "postal_code": "308164444",
            "telephone_number": "706-790-4440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEIGHBORHOOD IMPROVEMENT PROJECT INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-26",
        "last_updated": "2016-03-16",
        "status": "A",
        "authorized_official_last_name": "WOOD",
        "authorized_official_first_name": "WESLEY",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "706-790-4440"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Keysville, GA

Sources for this page

Verify at the official NPI Registry.