Jackson County Health Department
Organization Active NPI State or Local Public Health Clinic/Center · Jefferson, GA
NPI 1649317686 · NPPES record last updated Jul 23, 2025
Key facts
- NPI
- 1649317686
- Entity type
- Organization (NPI type 2)
- Primary specialty
- State or Local Public Health Clinic/Center 261QP0905X
- Legal business name
- JACKSON COUNTY HEALTH DEPARTMENT
- Practice address
- 341 Stan Evans Dr
Jefferson, GA 30549-2909 - Phone
- (706) 367-5204
- Fax
- (706) 367-9023
- NPI assigned
- Jan 31, 2007
- Organization subpart
- Yes
- Parent organization (as reported)
- JACKSON COUNTY HEALTH DEPARTMENT
Authorized official
- Name
- Donald S Goggans, MD
- Title
- Health Director
- Phone
- (706) 583-2870
Other NPIs on the same Medicare enrollment 1
Other NPIs with the same Medicare PAC ID 1
Practitioners 6
-
Gloria D'Laine Caldwell, M.S., R.N., WHNP-BC
-
Angela Maria Greene, RN, WHNP-BC
-
Ashleigh Danielle Grizzle, MSN, APRN, FNP-C
-
Sharon Lynn Lacount, FNP-BC
-
Carol Louise Marsden, F.N.P., A.P.R.N.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20050308000572 | GA | Part B Supplier - Mass Immunization (Roster Biller Only) | 8325092893 |
1 other NPI on this enrollment Practice locations: Commerce, GA; Jefferson, GA |
National Provider Directory
- Part of
- Jackson County Health Dept
Locations
341 Stan Evans Dr
Jefferson, GA 30549
Phone (706) 367-5204
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| State or Local Public Health Clinic/Center | 261QP0905X | Yes |
Addresses
Primary practice location
341 Stan Evans Dr
Jefferson, GA 30549-2909
Mailing address
341 Stan Evans Dr
Jefferson, GA 30549-2909
Phone (706) 367-5204
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000456574F | Medicaid | GA |
Other names
- JACKSON CO BD OF HLTH
Other providers in Jefferson, GA
- Independent Physical Therapy of Ga, LLC
- Infinite Consulting Empire, LLC
- Integrity Counseling and Personal Development LLC
- Dana Buck Irwin
- Jackson County B O C
- Jackson County Health Department
- Jackson County Health Department
- Jackson County School System
- Jackson County Senior Center
- Emma A James
All providers in Jefferson, GA · State or Local Public Health Clinic/Center in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 23, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.