NPIMap

Organization Active NPI

John D. Archbold Memorial Hospital, Inc.

Doing business as Archbold - Mitchell Specialty Clinic

  • Multi-Specialty Clinic/Center
  • Camilla, GA
National Provider Identifier
1740312099
Registry record updated Mar 8, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
JOHN D. ARCHBOLD MEMORIAL HOSPITAL, INC.
Doing business as
Archbold - Mitchell Specialty Clinic
Practice address
259 US Highway 19 N
Camilla, GA 31730-1410
Phone
(229) 336-8222
NPI assigned
Mar 12, 2007
Last updated
Mar 8, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2017

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

Authorized official

Name
Mr. Gregory S. Hembree
Title
Cfo
Phone
(229) 228-2880

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X NU Primary

Addresses

Primary practice location

259 US Highway 19 N
Camilla, GA 31730-1410

Mailing address

920 Cairo Rd
Thomasville, GA 31792-4255
Phone (229) 228-8800

Other identifiers 1

IdentifierTypeStateIssuer
136-91OtherGAPERMIT

Other names 1

  • Archbold - Mitchell Specialty Clinic Doing business as

National Provider Directory

National Provider Directory
Tax ID family
John D Archibold Mem Ho16 organizations share this tax ID, including this one

Other organizations with this tax ID 15

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

View all 15

Practitioners & affiliated clinicians

Practitioners 1

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": "1173657600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1488931200000",
    "number": "1740312099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "920 CAIRO RD",
            "city": "THOMASVILLE",
            "state": "GA",
            "postal_code": "317924255",
            "telephone_number": "229-228-8800",
            "fax_number": "229-228-8892"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "259 US HIGHWAY 19 N",
            "city": "CAMILLA",
            "state": "GA",
            "postal_code": "317301410",
            "telephone_number": "229-336-8222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHN D. ARCHBOLD MEMORIAL HOSPITAL, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-12",
        "last_updated": "2017-03-08",
        "status": "A",
        "authorized_official_last_name": "HEMBREE",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_middle_name": "S.",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "229-228-2880",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PERMIT",
            "identifier": "136-91",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Archbold - Mitchell Specialty Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Camilla, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.