NPIMap

Organization Active NPI

Crawford County Health Department

  • State or Local Public Health Clinic/Center
  • Roberta, GA
National Provider Identifier
1679583686
Registry record updated Jul 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
State or Local Public Health Clinic/CenterTaxonomy code 261QP0905X
Legal business name
CRAWFORD COUNTY HEALTH DEPARTMENT
Practice address
141 McCrary Ave
Roberta, GA 31078-4915
Phone
(478) 836-3167
Fax
(478) 836-2629
NPI assigned
Aug 9, 2006
Last updated
Jul 23, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2024

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

Authorized official

Name
Danielle McNair
Title
Authorized Official
Phone
(478) 751-6303

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Public Health or Welfare Agency 251K00000X
State or Local Public Health Clinic/Center 261QP0905X Primary

Addresses

Primary practice location

141 McCrary Ave
Roberta, GA 31078-4915

Mailing address

201 2ND St Ste 1100
Macon, GA 31201-6328
Phone (478) 297-5190

Other identifiers 4

IdentifierTypeStateIssuer
00456541KMedicaidGA
00733158AMedicaidGA
00460336DMedicaidGA
00051961DMedicaidGA

Other names 1

  • Crawford County Board of Health Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120213000176 GA Part B Supplier - Public Health/Welfare Agency 4082871488 Receives reassigned benefits from 2 practitioners
Practice locations: Roberta, GA

National Provider Directory

National Provider Directory

Locations

141 McCrary Ave
Roberta, GA 31078
Phone (478) 836-3167

301 McCrary Ave
Roberta, GA 31078

Practitioners & affiliated clinicians

Practitioners 10

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": "1155081600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721692800000",
    "number": "1679583686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 2ND ST STE 1100",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312016328",
            "telephone_number": "478-297-5190",
            "fax_number": "478-751-6099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "141 MCCRARY AVE",
            "city": "ROBERTA",
            "state": "GA",
            "postal_code": "310784915",
            "telephone_number": "478-836-3167",
            "fax_number": "478-836-2629"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRAWFORD COUNTY HEALTH DEPARTMENT",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-09",
        "last_updated": "2024-07-23",
        "certification_date": "2024-07-23",
        "status": "A",
        "authorized_official_last_name": "MCNAIR",
        "authorized_official_first_name": "DANIELLE",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "478-751-6303"
    },
    "taxonomies": [
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP0905X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Public Health, State or Local",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00456541K",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00733158A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00460336D",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00051961D",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Crawford County Board of Health",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Crawford County Board of Health",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Roberta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2024; 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.