NPIMap

Organization Active NPI

Highland Rivers CSB

  • Community/Behavioral Health Agency
  • Cedartown, GA
National Provider Identifier
1689737033
Registry record updated Sep 20, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
HIGHLAND RIVERS CSB
Practice address
180 Water Oak Dr
Cedartown, GA 30125-2095
Phone
(770) 748-2225
Fax
(770) 749-0939
NPI assigned
Dec 18, 2006
Last updated
Sep 20, 2011By the provider in NPPES
Organization subpart
Yes
Parent organization
HIGHLAND RIVERS CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 20, 2011

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

Authorized official

Name
Mr. Jason Bearden
Title
Ceo
Phone
(706) 270-5000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X GA Primary

Addresses

Primary practice location

180 Water Oak Dr
Cedartown, GA 30125-2095

Mailing address

1401 Applewood Drive
Suite 1
Dalton, GA 30720-2699
Phone (706) 270-5002

Other identifiers 2

IdentifierTypeStateIssuer
000759448JMedicaidGA
1447256243OtherGAORGANIZATIONAL MASTER NPI

Other names 1

  • HIGHLAND RIVERS POLK OP OFFICE AND CRISIS STABILIZATION PROGRAM Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040324001204 GA Part B Supplier - Clinic/Group Practice 9032000245 Receives reassigned benefits from 146 practitioners
16 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Rome, GA; Smyrna, GA; Marietta, GA; Jasper, GA; Hiram, GA; Ellijay, GA; Dalton, GA; Cedartown, GA…

Other NPIs on the same Medicare enrollment 16

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 16

National Provider Directory

National Provider Directory
Tax ID family
Highland Rivers Communi123 organizations share this tax ID, including this one
Part of
Highland Rivers Communi

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

180 Water Oak Dr
Cedartown, GA 30125
Phone (770) 748-0030

Practitioners & affiliated clinicians

Practitioners 29

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.

View all 29

NPI Registry JSON

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

{
    "created_epoch": "1166400000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1316476800000",
    "number": "1689737033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 APPLEWOOD DRIVE",
            "address_2": "SUITE 1",
            "city": "DALTON",
            "state": "GA",
            "postal_code": "307202699",
            "telephone_number": "706-270-5002",
            "fax_number": "706-370-7749"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "180 WATER OAK DR",
            "city": "CEDARTOWN",
            "state": "GA",
            "postal_code": "301252095",
            "telephone_number": "770-748-2225",
            "fax_number": "770-749-0939"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HIGHLAND RIVERS CSB",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "HIGHLAND RIVERS CENTER",
        "enumeration_date": "2006-12-18",
        "last_updated": "2011-09-20",
        "status": "A",
        "authorized_official_last_name": "BEARDEN",
        "authorized_official_first_name": "JASON",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "706-270-5000",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "GA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000759448J",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ORGANIZATIONAL MASTER NPI",
            "identifier": "1447256243",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "HIGHLAND RIVERS POLK OP OFFICE AND CRISIS STABILIZATION PROGRAM",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Cedartown, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2011; 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.