NPIMap

Organization Active NPI

Crisp Regional Hospital Inc

Doing business as Crisp Regional Urgent Care

  • Urgent Care Clinic/Center
  • Cordele, GA
National Provider Identifier
1710752076
Registry record updated Nov 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urgent Care Clinic/CenterTaxonomy code 261QU0200X
Legal business name
CRISP REGIONAL HOSPITAL INC
Doing business as
Crisp Regional Urgent Care
Practice address
1701 E 16TH Ave
Cordele, GA 31015-5308
Phone
(229) 276-2000
Fax
(229) 276-3634
NPI assigned
Nov 16, 2023
Last updated
Nov 16, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2023

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

Authorized official

Name
Jessica Yates Carter
Title
Cfo
Phone
(229) 276-3100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urgent Care Clinic/Center 261QU0200X Primary

Addresses

Primary practice location

1701 E 16TH Ave
Cordele, GA 31015-5308

Mailing address

PO Box 531739
Atlanta, GA 30353-1739
Phone (229) 276-3100

Other names 1

  • Crisp Regional Urgent Care Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
11D2007134Crisp Regional Urgent Care1701 16TH Avenue E, Cordele, GA 31015Certificate of waiverMay 11, 2028

National Provider Directory

National Provider Directory
Tax ID family
Crisp Regional Internal22 organizations share this tax ID, including this one

Other organizations with this tax ID 21

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

View all 21

NPI Registry JSON

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

{
    "created_epoch": "1700092800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1700092800000",
    "number": "1710752076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 531739",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303531739",
            "telephone_number": "229-276-3100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 E 16TH AVE",
            "city": "CORDELE",
            "state": "GA",
            "postal_code": "310155308",
            "telephone_number": "229-276-2000",
            "fax_number": "229-276-3634"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRISP REGIONAL HOSPITAL INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-11-16",
        "last_updated": "2023-11-16",
        "certification_date": "2023-11-16",
        "status": "A",
        "authorized_official_last_name": "CARTER",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_middle_name": "YATES",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "229-276-3100"
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Crisp Regional Urgent Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Cordele, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.