NPIMap

Organization Active NPI

Brooks County Hospital

Doing business as Brooks County Hospital - vRadFL

  • Diagnostic Radiology Physician
  • Quitman, GA
National Provider Identifier
1639523087
Registry record updated Aug 29, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
BROOKS COUNTY HOSPITAL
Doing business as
Brooks County Hospital - vRadFL
Practice address
903 N Court St
Quitman, GA 31643
Phone
(229) 263-4171
NPI assigned
Apr 21, 2016
Last updated
Aug 29, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2018

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

Authorized official

Name
Mr. Gregory S. Hembree
Title
Senior Vice President and Cfo
Phone
(229) 228-2880

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X Primary

Addresses

Primary practice location

903 N Court St
Quitman, GA 31643

Mailing address

920 Cairo Rd
Thomasville, GA 31792-4255
Phone (229) 228-8800

Other names 1

  • Brooks County Hospital - vRadFL Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20161202002034 FL Part B Supplier - Clinic/Group Practice 1557279049 Receives reassigned benefits from 3 practitioners
Practice locations: Lakewood Ranch, FL; Palm City, FL; Ponte Vedra Beach, FL

Other NPIs with the same Medicare PAC ID 2

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

National Provider Directory

National Provider Directory
Tax ID family
Archbold Brooks6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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

Practitioners & affiliated clinicians

Practitioners 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1461196800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1535500800000",
    "number": "1639523087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "920 CAIRO RD",
            "city": "THOMASVILLE",
            "state": "GA",
            "postal_code": "317924255",
            "telephone_number": "229-228-8800",
            "fax_number": "229-228-8892"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "903 N COURT ST",
            "city": "QUITMAN",
            "state": "GA",
            "postal_code": "31643",
            "telephone_number": "229-263-4171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROOKS COUNTY HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-21",
        "last_updated": "2018-08-29",
        "status": "A",
        "authorized_official_last_name": "HEMBREE",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_middle_name": "S.",
        "authorized_official_title_or_position": "SENIOR VICE PRESIDENT AND CFO",
        "authorized_official_telephone_number": "229-228-2880",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Brooks County Hospital - vRadFL",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Quitman, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.