Organization Active NPI

Polk County Board of Health

  • Public Health or Welfare Agency
  • Cedartown, GA
National Provider Identifier
1710087960
Registry record updated Aug 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Public Health or Welfare AgencyTaxonomy code 251K00000X
Legal business name
POLK COUNTY BOARD OF HEALTH
Practice address
125 E Ware St
Cedartown, GA 30125-3051
Phone
(770) 749-2270
Fax
(770) 749-2298
NPI assigned
Sep 25, 2006
Last updated
Aug 30, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2024

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

Authorized official

Name
Gary Voccio, MD
Title
District Health Director
Phone
(706) 295-6704

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Public Health or Welfare Agency 251K00000X GA Primary

Addresses

Primary practice location

125 E Ware St
Cedartown, GA 30125-3051

Mailing address

125 E Ware St
Cedartown, GA 30125-3051
Phone (770) 749-2270

Other identifiers 4

IdentifierTypeStateIssuer
000619605IMedicaidGA
0000699212AMedicaidGA
000457751JMedicaidGA
000051829JMedicaidGA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100420000579 GA Part B Supplier - Public Health/Welfare Agency 5991604316 1 other NPI on this enrollment
Practice locations: Cedartown, GA

Other NPIs on the same Medicare enrollment 1

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

National Provider Directory

National Provider Directory
Tax ID family
Polk County Board of Health3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Practitioners & affiliated clinicians

Practitioners 3

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": "1159142400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724976000000",
    "number": "1710087960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 E WARE ST",
            "city": "CEDARTOWN",
            "state": "GA",
            "postal_code": "301253051",
            "telephone_number": "770-749-2270",
            "fax_number": "770-749-2298"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 E WARE ST",
            "city": "CEDARTOWN",
            "state": "GA",
            "postal_code": "301253051",
            "telephone_number": "770-749-2270",
            "fax_number": "770-749-2298"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POLK COUNTY BOARD OF HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-25",
        "last_updated": "2024-08-30",
        "certification_date": "2024-08-30",
        "status": "A",
        "authorized_official_last_name": "VOCCIO",
        "authorized_official_first_name": "GARY",
        "authorized_official_title_or_position": "DISTRICT HEALTH DIRECTOR",
        "authorized_official_telephone_number": "706-295-6704",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": "GA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000619605I",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0000699212A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000457751J",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000051829J",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 Aug 30, 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.