Southwest Ga Primary Care, LLC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

33367 Issued in GA

Legal business name

SOUTHWEST GA PRIMARY CARE, LLC

Practice address

93 S Broad St
Ellaville, GA 31806-0989

Phone

(229) 410-9965

Fax

(229) 937-9007

NPI assigned

Aug 5, 2013

Organization subpart

No

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

Authorized official

Name

Linda P Hamsley, FNP-C

Title

Owner

Phone

(229) 410-9965

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1375660800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1401926400000",
    "number": "1629400312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 989",
            "city": "ELLAVILLE",
            "state": "GA",
            "postal_code": "318060989",
            "telephone_number": "229-410-9965",
            "fax_number": "229-937-9007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "93 S BROAD ST",
            "city": "ELLAVILLE",
            "state": "GA",
            "postal_code": "318060989",
            "telephone_number": "229-410-9965",
            "fax_number": "229-937-9007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHWEST GA PRIMARY CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-08-05",
        "last_updated": "2014-06-05",
        "status": "A",
        "authorized_official_last_name": "HAMSLEY",
        "authorized_official_first_name": "LINDA",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "229-410-9965",
        "authorized_official_credential": "FNP-C"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "GA",
            "license": "33367",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000506437G",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Schley County Commissioner
• Schley County Schools
• Maryanne Shephard, NURSE PRACTIONER
• Kristy Joy Smith, FNP-C
• Laci Smith, RN
• Sumter Regional Hospital
• Sumter Regional Hospital
• Rebecca Faye Williams, PHARMD

• Primary Care Clinic/Center in Ellaville, GA
• Providers in Ellaville, GA by specialty
• Primary Care Clinic/Center in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2014; 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.