Green Oaks Center

Primary specialty

Developmental Disabilities Clinic/CenterTaxonomy code 261QD1600X

Legal business name

GREEN OAKS CENTER

Practice address

2443 Ga Hwy 133 South
Moultrie, GA 31788

Phone

(229) 891-7300

Fax

(229) 891-7303

NPI assigned

Jun 26, 2023

Last updated

Jun 26, 2023By 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

Michelle Folsom

Title

Clinical Coordinator

Phone

(229) 891-7300

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1687737600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1687737600000",
    "number": "1639855539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2443 GA HWY 133 SOUTH PO BOX 2677",
            "city": "MOULTRIE",
            "state": "GA",
            "postal_code": "31788",
            "telephone_number": "229-891-7300",
            "fax_number": "229-891-7303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2443 GA HWY 133 SOUTH",
            "city": "MOULTRIE",
            "state": "GA",
            "postal_code": "31788",
            "telephone_number": "229-891-7300",
            "fax_number": "229-891-7303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREEN OAKS CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-06-26",
        "last_updated": "2023-06-26",
        "certification_date": "2023-06-26",
        "status": "A",
        "authorized_official_last_name": "FOLSOM",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_title_or_position": "CLINICAL COORDINATOR",
        "authorized_official_telephone_number": "229-891-7300"
    },
    "taxonomies": [
        {
            "code": "261QD1600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Developmental Disabilities",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Johnny Levar Gosier, D.M.D.
• Matthew Gould, PA
• Matthew Adam Graham, MD
• Keith Woodward Gramling Jr., DO
• Justin Wayne Graves, LCSW
• Green Terrace
• David Michael Green, MD
• Ava Dawn Greene, FNP-C
• Jesse Nathan Greene
• Michael Brandon Griffin, PHARMD

• Developmental Disabilities Clinic/Center in Moultrie, GA
• Providers in Moultrie, GA by specialty
• Developmental Disabilities Clinic/Center in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2023; 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.