NPIMap

Organization Active NPI

CSB of East Central Georgia

  • Developmental Disabilities Clinic/Center
  • Augusta, GA
National Provider Identifier
1659544369
Registry record updated Jun 19, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmental Disabilities Clinic/CenterTaxonomy code 261QD1600X
Legal business name
CSB OF EAST CENTRAL GEORGIA
Practice address
3421 Mike Padgett Hwy
Augusta, GA 30906-3815
Phone
(706) 432-4858
Fax
(706) 432-3780
NPI assigned
Apr 3, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2008

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

Authorized official

Name
Wanda Jessie
Title
Billing Supervisor
Phone
(706) 432-4858

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Developmental Disabilities Clinic/Center 261QD1600X GA Primary

Addresses

Primary practice location

3421 Mike Padgett Hwy
Augusta, GA 30906-3815

Mailing address

3421 Mike Padgett Hwy
Augusta, GA 30906-3815
Phone (706) 432-4858

Other identifiers 1

IdentifierTypeStateIssuer
00605833EMedicaidGA

National Provider Directory

National Provider Directory
Tax ID family
CSB of East Central Ga49 organizations share this tax ID, including this one

Other organizations with this tax ID 48

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

View all 48

NPI Registry JSON

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

{
    "created_epoch": "1207180800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213833600000",
    "number": "1659544369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3421 MIKE PADGETT HWY",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309063815",
            "telephone_number": "706-432-4858",
            "fax_number": "706-432-3780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3421 MIKE PADGETT HWY",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309063815",
            "telephone_number": "706-432-4858",
            "fax_number": "706-432-3780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CSB OF EAST CENTRAL GEORGIA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-03",
        "last_updated": "2008-06-19",
        "status": "A",
        "authorized_official_last_name": "JESSIE",
        "authorized_official_first_name": "WANDA",
        "authorized_official_title_or_position": "BILLING SUPERVISOR",
        "authorized_official_telephone_number": "706-432-4858"
    },
    "taxonomies": [
        {
            "code": "261QD1600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Developmental Disabilities",
            "state": "GA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00605833E",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Augusta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2008; 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.