NPIMap

Organization Active NPI

Ga Department of Human Resources

Doing business as East Central Regional Hospital

  • Psychiatric Hospital Unit
  • Augusta, GA
National Provider Identifier
1699877068
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric Hospital UnitTaxonomy code 273R00000X
License
121231 Issued in GA
Legal business name
GA DEPARTMENT OF HUMAN RESOURCES
Doing business as
East Central Regional Hospital
Practice address
3405 Mike Padgett Hwy
Augusta, GA 30906-3815
Phone
(706) 790-2042
Fax
(706) 790-2476
NPI assigned
Sep 5, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Gail C Jackson, M.D.
Title
Regional Hospital Administrator
Phone
(706) 790-2030

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric Hospital Unit 273R00000X 121231 GA Primary

Addresses

Primary practice location

3405 Mike Padgett Hwy
Augusta, GA 30906-3815

Mailing address

3405 Mike Padgett Hwy
Augusta, GA 30906-3815
Phone (706) 790-2042

Other names 1

  • East Central Regional Hospital Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20101102000975 GA Part A Provider - Hospital 2163320250 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Augusta, GA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1699877068. Details of each certification follow.

Hospital certification: CCN 114029

Legal name
DEPARTMENT OF BEHAVIORAL HEALTH AND DEVELOPMENTAL DISABILITIES
Doing business as
EAST CENTRAL REGIONAL HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Psychiatric
Participating since
Jul 1, 1987
Last certification
Feb 7, 2025
Beds
355 (132 certified)
Ownership / control type
State
Organization structure
GovernmentNon-profit
Enrollment address
3405 Mike Padgett Hwy
Augusta, GA 30906-3815
Hospital Psychiatric Unit
Hospital subgroups
Psychiatric unit

Other NPIs on the same Medicare enrollment 1

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

Care Compare: Hospital

Medicare Care Compare
Listed as
East Central Regional HospitalCCN 114029 · All quality measures
Type
Psychiatric
Ownership
Government - State
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
No

National Provider Directory

National Provider Directory
Tax ID family
Ga Department of Behavioral Health and Developmental Disabilities74 organizations share this tax ID, including this one

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

3405 Mike Padgett Hwy
Ofc
Augusta, GA 30906

Ownership & related parties

All disclosed owners & managing parties 3

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Department of Behavioral Health and Developmental Disabilities Organization, Augusta, GA Medical provider/supplier 5% Or Greater Direct Ownership Interest Jul 1, 2009 100%
Other Jul 1, 2009 100%
Carletta Johnson Individual Corporate OfficerChief Financial Officer Nov 1, 2021
W-2 Managing EmployeeChief Financial Officer Nov 1, 2021
Tammi Brown Individual Corporate DirectorRegional Hospital Administrator Sep 1, 2021 100%

Owners & managing parties with NPI records 3

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

NPI Registry JSON

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

{
    "created_epoch": "1157414400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1699877068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3405 MIKE PADGETT HWY",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309063815",
            "telephone_number": "706-790-2042",
            "fax_number": "706-790-2476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3405 MIKE PADGETT HWY",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309063815",
            "telephone_number": "706-790-2042",
            "fax_number": "706-790-2476"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GA DEPARTMENT OF HUMAN RESOURCES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-05",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "GAIL",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "REGIONAL HOSPITAL ADMINISTRATOR",
        "authorized_official_telephone_number": "706-790-2030",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "273R00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Unit",
            "state": "GA",
            "license": "121231",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "East Central Regional Hospital",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Augusta, GA

Sources for this page

Verify at the official NPI Registry.