NPIMap

Organization Active NPI

Glynn County Board of Health

Doing business as Glynn County Health Department

  • Public Health or Welfare Agency
  • Brunswick, GA
National Provider Identifier
1730187188
Registry record updated Jan 6, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Public Health or Welfare AgencyTaxonomy code 251K00000X
Legal business name
GLYNN COUNTY BOARD OF HEALTH
Doing business as
Glynn County Health Department
Practice address
2747 4TH St
Brunswick, GA 31520-3714
Phone
(912) 262-2347
Fax
(912) 262-3036
NPI assigned
Jul 11, 2005
Last updated
Jan 6, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2015

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

Authorized official

Name
Mrs. Stacy A Cooper
Title
District Billing Dept. Coordinator
Phone
(912) 262-2347

Specialties & licenses 1

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

Addresses

Primary practice location

2747 4TH St
Brunswick, GA 31520-3714

Mailing address

150 Scranton Connector
Brunswick, GA 31525-0540
Phone (912) 262-2347

Other identifiers 6

IdentifierTypeStateIssuer
000453219JMedicaidGA
000457938AMedicaidGA
000456508FMedicaidGA
000551933AMedicaidGA
000051818DMedicaidGA
FLU143OtherGAMEDICARE NUMBER

Other names 1

  • Glynn County Health Department Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050328000406 GA Part B Supplier - Public Health/Welfare Agency 4385532456 Practice locations: Brunswick, GA

Other NPIs with the same Medicare PAC ID 1

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

National Provider Directory

National Provider Directory
Tax ID family
Glynn County Health Dept5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

Ownership & related parties

Subparts reporting this organization as parent 2

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

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": "1121040000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1420502400000",
    "number": "1730187188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 SCRANTON CONNECTOR",
            "city": "BRUNSWICK",
            "state": "GA",
            "postal_code": "315250540",
            "telephone_number": "912-262-2347",
            "fax_number": "912-262-3036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2747 4TH ST",
            "city": "BRUNSWICK",
            "state": "GA",
            "postal_code": "315203714",
            "telephone_number": "912-262-2347",
            "fax_number": "912-262-3036"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLYNN COUNTY BOARD OF HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-11",
        "last_updated": "2015-01-06",
        "status": "A",
        "authorized_official_last_name": "COOPER",
        "authorized_official_first_name": "STACY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "DISTRICT BILLING DEPT. COORDINATOR",
        "authorized_official_telephone_number": "912-262-2347",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000453219J",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000457938A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000456508F",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000551933A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000051818D",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE NUMBER",
            "identifier": "FLU143",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Glynn County Health Department",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Brunswick, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2015; 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.