NPIMap

Organization Active NPI

Phoebe Dorminy Medical Center, Inc.

Doing business as Phoebe Dorminy Care Clinic

  • Rural Health Clinic/Center
  • Fitzgerald, GA
National Provider Identifier
1619255189
Registry record updated Nov 8, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
PHOEBE DORMINY MEDICAL CENTER, INC.
Doing business as
Phoebe Dorminy Care Clinic
Practice address
182 Perry House Rd
Ste. B
Fitzgerald, GA 31750-8721
Phone
(229) 424-7263
Fax
(229) 424-7281
NPI assigned
Aug 1, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2011

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

Authorized official

Name
Mrs. Paige P Wynn
Title
Cfo
Phone
(229) 424-7100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X Primary

Addresses

Primary practice location

182 Perry House Rd
Ste. B
Fitzgerald, GA 31750-8721

Mailing address

200 Perry House Rd
Fitzgerald, GA 31750-8857
Phone (229) 424-7100

Other names 1

  • Phoebe Dorminy Care Clinic Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Phoebe Dorminy Medical Center4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Locations

182 Perry House Rd
Ste B
Fitzgerald, GA 31750
Phone (229) 424-7263

NPI Registry JSON

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

{
    "created_epoch": "1312156800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1320710400000",
    "number": "1619255189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 PERRY HOUSE RD",
            "city": "FITZGERALD",
            "state": "GA",
            "postal_code": "317508857",
            "telephone_number": "229-424-7100",
            "fax_number": "229-424-7281"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "182 PERRY HOUSE RD",
            "address_2": "STE. B",
            "city": "FITZGERALD",
            "state": "GA",
            "postal_code": "317508721",
            "telephone_number": "229-424-7263",
            "fax_number": "229-424-7281"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHOEBE DORMINY MEDICAL CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-01",
        "last_updated": "2011-11-08",
        "status": "A",
        "authorized_official_last_name": "WYNN",
        "authorized_official_first_name": "PAIGE",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "229-424-7100",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Phoebe Dorminy Care Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fitzgerald, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2011; 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.