NPIMap

Organization Active NPI

Department of Behavioral Health and Developmental Disabilities

  • Psychiatric Hospital
  • Rome, GA
National Provider Identifier
1760617229
Registry record updated Jan 29, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric HospitalTaxonomy code 283Q00000X
License
057013 Issued in GA
Legal business name
DEPARTMENT OF BEHAVIORAL HEALTH AND DEVELOPMENTAL DISABILITIES
Practice address
705 N Division St NW
Rome, GA 30165-1454
Phone
(706) 295-6298
NPI assigned
May 27, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2010

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

Authorized official

Name
Thomas Muller, M.D.
Title
Clinical Director
Phone
(706) 295-6285

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric Hospital 283Q00000X 057013 GA Primary

Addresses

Primary practice location

705 N Division St NW
Rome, GA 30165-1454

Mailing address

705 N Division St NW
Rome, GA 30165-1454
Phone (706) 295-6298

Other identifiers 2

IdentifierTypeStateIssuer
112002GAOtherGAMEDICARE PART B
000142172AMedicaidGA

Other names 1

  • Northwest Georgia Regional Hospital Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090825000435 GA Part B Supplier - Clinic/Group Practice 7416002506 Receives reassigned benefits from 178 practitioners
7 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Augusta, GA; Columbus, GA; Decatur, GA; Milledgeville, GA; Rome, GA; Savannah, GA; Thomasville, GA

Other NPIs on the same Medicare enrollment 7

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

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1243382400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1264723200000",
    "number": "1760617229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "705 N DIVISION ST NW",
            "city": "ROME",
            "state": "GA",
            "postal_code": "301651454",
            "telephone_number": "706-295-6298"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "705 N DIVISION ST NW",
            "city": "ROME",
            "state": "GA",
            "postal_code": "301651454",
            "telephone_number": "706-295-6298"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEPARTMENT OF BEHAVIORAL HEALTH AND DEVELOPMENTAL DISABILITIES",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-05-27",
        "last_updated": "2010-01-29",
        "status": "A",
        "authorized_official_last_name": "MULLER",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "706-295-6285",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "283Q00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Hospital",
            "state": "GA",
            "license": "057013",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PART B",
            "identifier": "112002GA",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000142172A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Northwest Georgia Regional Hospital",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Rome, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2010; 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.