Hospital Authority of Ben Hill

Organization Active NPI Medicare Defined Swing Bed Hospital Unit · Fitzgerald, GA

NPI 1720173917 · NPPES record last updated Jul 23, 2009

Key facts

NPI
1720173917
Entity type
Organization (NPI type 2)
Primary specialty
Medicare Defined Swing Bed Hospital Unit 275N00000X
Legal business name
HOSPITAL AUTHORITY OF BEN HILL
Practice address
200 Perry House Rd
Fitzgerald, GA 31750-8857
Phone
(229) 424-7100
NPI assigned
Oct 4, 2006
Organization subpart
No

Authorized official

Name
Mrs. Paige P Wynn
Title
Cfo
Phone
(229) 424-7100

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Other NPIs with the same Medicare PAC ID 3

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Facilities connected through Provider of Services related, parent or unit certification numbers.

Affiliated clinicians 1

Clinicians who list this facility as an affiliation in Medicare Care Compare.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in GA

Hospital certification: CCN 11Z339

Legal name
HOSPITAL AUTHORITY OF BEN HILL
Doing business as
DORMINY MEMORIAL HOSPITAL
Organization structure
Other · Non-profit
Enrollment address
200 Perry House Rd
Fitzgerald, GA 31750-8857
Hospital Swing-Bed Unit
Hospital subgroups
Swing-bed approved

All disclosed owners & managing parties 2

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

NameRoleSinceShare
Nate Wilson
Individual
Corporate Director
Cfo
Mar 18, 2026
W-2 Managing Employee Mar 18, 2026
Paige P Wynn
Individual
Corporate Director
Ceo
Mar 18, 2026
W-2 Managing Employee Mar 18, 2026

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
DMC Internal Medicine and Family Health Clinic
Fitzgerald, GA · CCN 113466
Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Nov 1, 2014

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20260512001082 GA Part a Provider - Hospital 3678461373 Practice locations: Fitzgerald, GA

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Medicare Defined Swing Bed Hospital Unit 275N00000X Yes

Addresses

Primary practice location

200 Perry House Rd
Fitzgerald, GA 31750-8857

Mailing address

200 Perry House Rd
Fitzgerald, GA 31750-8857
Phone (229) 424-7100

Other names

  • Dorminy Medical Center Swingbed Doing business as

Other providers in Fitzgerald, GA

All providers in Fitzgerald, GA · Medicare Defined Swing Bed Hospital Unit in Georgia

Sources for this page

Verify at the official NPI Registry.