Clay County Community Health Center, Inc.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

CLAY COUNTY COMMUNITY HEALTH CENTER, INC.

Practice address

305 Washington St S
Fort Gaines, GA 39851-4315

Phone

(229) 768-3889

NPI assigned

Apr 27, 2018

Last updated

Apr 27, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Stephanie Gill

Title

Provider Enrollment Specialist

Phone

(470) 233-0545

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1524787200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1524787200000",
    "number": "1609364462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 281",
            "city": "FORT GAINES",
            "state": "GA",
            "postal_code": "398510281",
            "telephone_number": "229-768-3888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 WASHINGTON ST S",
            "city": "FORT GAINES",
            "state": "GA",
            "postal_code": "398514315",
            "telephone_number": "229-768-3889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLAY COUNTY COMMUNITY HEALTH CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-04-27",
        "last_updated": "2018-04-27",
        "status": "A",
        "authorized_official_last_name": "GILL",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_title_or_position": "PROVIDER ENROLLMENT SPECIALIST",
        "authorized_official_telephone_number": "470-233-0545"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Albany Area Primary Health Care, Inc. (Clay County School-Based Health Center)
• Temeka Taylor Buggs
• Clay County Board of Commissioners (Clay County EMS)
• Clay County Board of Health
• Clay County Medical Center, PC
• Clay County School System
• Jessica Michelle Collins, APRN
• Cricket Drugs, Inc
• Cricket Drugs, Inc

• Internal Medicine Physician in Fort Gaines, GA
• Providers in Fort Gaines, GA by specialty
• Internal Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2018; 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.