NPIMap

Organization Active NPI

Gwinnett County Health Department

  • Public Health or Welfare Agency
  • Lawrenceville, GA
National Provider Identifier
1720175169
Registry record updated Jun 16, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Public Health or Welfare AgencyTaxonomy code 251K00000X
Legal business name
GWINNETT COUNTY HEALTH DEPARTMENT
Practice address
455 Grayson Hwy
Lawrenceville, GA 30045-7171
Phone
(770) 339-4283
NPI assigned
Oct 6, 2006
Organization subpart
Yes
Parent organization
GWINNETT COUNTY HEALTH DEPARTMENTAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 16, 2008

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

Authorized official

Name
Lloyd M Hofer, MD MPH
Title
Director
Phone
(770) 339-4260

Specialties & licenses 1

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

Addresses

Primary practice location

455 Grayson Hwy
Lawrenceville, GA 30045-7171

Mailing address

PO Box 897
Lawrenceville, GA 30046-0897

Other identifiers 6

IdentifierTypeStateIssuer
000051917BMedicaidGA
000956194CMedicaidGA
000452889AMedicaidGA
000455881AMedicaidGA
000058517EMedicaidGA
000456486CMedicaidGA

Other names 1

  • Gwinnett County Public Health Services Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20111114000567 GA Part B Supplier - Public Health/Welfare Agency 5799959557 4 other NPIs on this enrollment
Practice locations: Lawrenceville, GA; Snellville, GA; Norcross, GA; Buford, GA

Other NPIs on the same Medicare enrollment 4

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

National Provider Directory

National Provider Directory
Tax ID family
County of Gwinnett Heal7 organizations share this tax ID, including this one
Part of
County of Gwinnett Heal

Other organizations with this tax ID 6

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

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1160092800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213574400000",
    "number": "1720175169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 897",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300460897"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "455 GRAYSON HWY",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300457171",
            "telephone_number": "770-339-4283"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GWINNETT COUNTY HEALTH DEPARTMENT",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GWINNETT COUNTY HEALTH DEPARTMENT",
        "enumeration_date": "2006-10-06",
        "last_updated": "2008-06-16",
        "status": "A",
        "authorized_official_last_name": "HOFER",
        "authorized_official_first_name": "LLOYD",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "770-339-4260",
        "authorized_official_credential": "MD MPH"
    },
    "taxonomies": [
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000051917B",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000956194C",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000452889A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000455881A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000058517E",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000456486C",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Gwinnett County Public Health Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lawrenceville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2008; 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.