NPIMap

Organization Active NPI

First Choice Primary Care, Inc

Doing business as Ingram-Pye Health Center

  • Federally Qualified Health Center (FQHC)
  • Macon, GA
National Provider Identifier
1740666767
Registry record updated Jul 31, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
FIRST CHOICE PRIMARY CARE, INC
Doing business as
Ingram-Pye Health Center
Practice address
855 Anthony Rd
Macon, GA 31204-6266
Phone
(478) 787-4266
Fax
(478) 787-4199
NPI assigned
Jul 31, 2015
Last updated
Jul 31, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2015

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

Authorized official

Name
Katherine McLeod, CEO
Title
Ceo
Phone
(478) 787-4266

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

855 Anthony Rd
Macon, GA 31204-6266

Mailing address

PO Box 4363
Macon, GA 31208-4363
Phone (478) 787-4266

Other names 1

  • Ingram-Pye Health Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150929003106 GA Part A Provider - Federally Qualified Health Center (FQHC) 6103907316 Practice locations: Macon, GA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1740666767. Details of each certification follow.

Federally qualified health center certification: CCN 111014

Legal name
FIRST CHOICE PRIMARY CARE, INC.
Doing business as
INGRAM-PYE HEALTH CENTER
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Sep 29, 2015
Last certification
Sep 29, 2015
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Oct 27, 2005 in GA
Enrollment address
855 Anthony Rd
Macon, GA 31204-6266

Other NPIs with the same Medicare PAC ID 6

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

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
11D2101428Ingram Pye Health Center855 Anthony Rd, Macon, GA 31204Certificate of waiverSep 3, 2027

National Provider Directory

National Provider Directory
Tax ID family
First Choice Prim Careinc9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

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

Ownership & related parties

All disclosed owners & managing parties 9

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

NameRoleSinceShare
Camille Hope Individual Operational/Managerial ControlBoard Member Nov 1, 2007 5%
Thomas Duval Individual Operational/Managerial ControlBoard Member Nov 1, 2007 10%
Elbert McQueen Individual Operational/Managerial ControlBoard Member Jul 1, 2015 10%
David C Parish Individual 5% Or Greater Direct Ownership Interest Sep 1, 2011
Operational/Managerial ControlBoard Member Sep 1, 2011
Jonathan Alderman Individual Operational/Managerial ControlBoard Member Nov 1, 2007 10%
Katherine McLeod Individual Corporate OfficerChief Executive Officer Nov 1, 2007 5%
W-2 Managing EmployeeCeo Nov 1, 2007 5%
Linda Holland Individual Operational/Managerial ControlBoard Member Jan 1, 2011 10%
Steven Corkery Individual Operational/Managerial ControlBoard Member Jan 1, 2011 10%
Marc Whitfield Individual Operational/Managerial ControlBoard Member Nov 1, 2007 10%

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

  • David C Parish, MD
    • Internal Medicine Physician
    • Macon, GA
    • NPI 1790861631

    5% Or Greater Direct Ownership Interest, Operational/Managerial Control

    CMS ownership

All facility ownership & control disclosures 2

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

FacilityTypeRoleSince
First Choice Primary Care, Inc.Macon, GA, CCN 111069 Federally qualified health center Operational/Managerial Control (100%) Nov 1, 2007
FCPC Bruce Elementary SBHCMacon, GA, CCN C21039 Federally qualified health center Operational/Managerial Control (100%) May 1, 2025

Owned or controlled facilities with NPI records 2

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

Practitioners & affiliated clinicians

Practitioners 2

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": "1438300800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1438300800000",
    "number": "1740666767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4363",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312084363",
            "telephone_number": "478-787-4266",
            "fax_number": "478-787-4199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "855 ANTHONY RD",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312046266",
            "telephone_number": "478-787-4266",
            "fax_number": "478-787-4199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FIRST CHOICE PRIMARY CARE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-31",
        "last_updated": "2015-07-31",
        "status": "A",
        "authorized_official_last_name": "MCLEOD",
        "authorized_official_first_name": "KATHERINE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "478-787-4266",
        "authorized_official_credential": "CEO"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ingram-Pye Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Macon, GA

Sources for this page

Verify at the official NPI Registry.