NPIMap

Organization Active NPI

Bacon County Health Services, Inc.

  • Critical Access Hospital
  • Alma, GA
National Provider Identifier
1629185285
Registry record updated Jun 24, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Access HospitalTaxonomy code 282NC0060X
Legal business name
BACON COUNTY HEALTH SERVICES, INC.
Practice address
302 S Wayne St
Alma, GA 31510-2922
Phone
(912) 632-8961
Fax
(912) 632-5000
NPI assigned
Aug 23, 2006
Last updated
Jun 24, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2010

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

Authorized official

Name
Cindy R Turner, CEO
Title
Chief Executive Officer
Phone
(912) 632-8961

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Access Hospital 282NC0060X Primary

Addresses

Primary practice location

302 S Wayne St
Alma, GA 31510-2922

Mailing address

PO Drawer 1987
302 South Wayne Street
Alma, GA 31510-0987
Phone (912) 632-8961

Other identifiers 1

IdentifierTypeStateIssuer
00000118AMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040127001164 GA Part B Supplier - Clinic/Group Practice 1850294034 Receives reassigned benefits from 13 practitioners
3 other NPIs on this enrollment
Practice locations: Alma, GA
O20230202003276 GA Part A Provider - Critical Access Hospital 1850294034 Receives reassigned benefits from 1 practitioner
Practice locations: Alma, GA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1629185285. Details of each certification follow.

Hospital certification: CCN 111327

Legal name
BACON COUNTY HEALTH SERVICES, INC.
Certification status
Active
Provider type (POS)
Hospital – Critical access hospital
Participating since
Jul 1, 2002
Last certification
Feb 13, 2025
Beds
25
Ownership / control type
Other
Organization structure
CorporationNon-profit
Incorporated
Jun 15, 1995 in GA
Enrollment address
302 S Wayne St
Alma, GA 31510-2922
Other Hospital Practice Location

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 4

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

Other NPIs on the same Medicare enrollment 3

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

Care Compare: Hospital

Medicare Care Compare
Listed as
Bacon County HospitalCCN 111327 · All quality measures
Type
Critical Access Hospitals
Ownership
Voluntary non-profit - Other
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
No

National Provider Directory

National Provider Directory

Locations

301 S Baker St
Alma, GA 31510
Phone (912) 632-2952

3406 Wildwood Dr
Patterson, GA 31557
Phone (912) 647-2952

1406 Habersham Dr
Waycross, GA 31501
Phone (912) 287-0333

2003 Alice St
Ste A
Waycross, GA 31501
Phone (912) 285-0053

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
Roger Staten Individual Corporate DirectorBoard Member Nov 26, 2007
Cindy Turner Individual Corporate OfficerCeo Sep 1, 2005
W-2 Managing EmployeeCeo Sep 1, 2005
Palmer Jordan Individual Corporate DirectorBoard Member Nov 26, 2007
Albert Wildes Individual Corporate DirectorBoard Member Jul 1, 2011
Cheryl C Dubose Individual Corporate OfficerChief Operating Officer Sep 13, 2006
Corporate DirectorDir of Financial Services Sep 13, 2006
W-2 Managing EmployeeCfo Sep 13, 2016
Daniel Johnson Individual Corporate DirectorBoard Member Jun 17, 2022
Charlene Bennett Individual Corporate DirectorBoard Member Nov 26, 2007
Robert Stanaland Individual Corporate DirectorBoard Member Nov 26, 2007
Belinda Medders Individual W-2 Managing EmployeePhysician Credentialing Coordinator Oct 5, 2007

All facility ownership & control disclosures 3

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

FacilityTypeRoleSince
Twin Oaks Convalescent CenterAlma, GA, CCN 115513 Skilled nursing facility Operational/Managerial Control Nov 26, 2007
Bacon County Community Care CenterAlma, GA, CCN 113408 Rural health clinic 5% Or Greater Direct Ownership Interest
Operational/Managerial Control		 Dec 17, 2012
Nov 20, 2002
Nicholls Family HealthcareNicholls, GA, CCN 118560 Rural health clinic Operational/Managerial Control (100%) Jul 10, 2017

Owned or controlled facilities with NPI records 3

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

Practitioners & affiliated clinicians

Practitioners 16

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 16

Affiliated clinicians 114

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 114

NPI Registry JSON

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

{
    "created_epoch": "1156291200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1277337600000",
    "number": "1629185285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO DRAWER 1987",
            "address_2": "302 SOUTH WAYNE STREET",
            "city": "ALMA",
            "state": "GA",
            "postal_code": "315100987",
            "telephone_number": "912-632-8961",
            "fax_number": "912-632-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "302 S WAYNE ST",
            "city": "ALMA",
            "state": "GA",
            "postal_code": "315102922",
            "telephone_number": "912-632-8961",
            "fax_number": "912-632-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BACON COUNTY HEALTH SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-23",
        "last_updated": "2010-06-24",
        "status": "A",
        "authorized_official_last_name": "TURNER",
        "authorized_official_first_name": "CINDY",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "912-632-8961",
        "authorized_official_credential": "CEO"
    },
    "taxonomies": [
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00000118A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Alma, GA

Sources for this page

Verify at the official NPI Registry.