NPIMap

Organization Active NPI

Elbert Memorial Hospital

Doing business as Hartwell Family Clinic - Elbert Memorial Hospital

  • Rural Health Clinic/Center
  • Hartwell, GA
National Provider Identifier
1770322117
Registry record updated Jan 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
ELBERT MEMORIAL HOSPITAL
Doing business as
Hartwell Family Clinic - Elbert Memorial Hospital
Practice address
1029 E Franklin St
Suite D
Hartwell, GA 30643
Phone
(706) 213-3151
NPI assigned
May 24, 2024
Last updated
Jan 23, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
ELBERTON-ELBERT COUNTY HOSPITAL AUTHORITYAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 23, 2025

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

Authorized official

Name
Mr. John Tyler Taylor
Title
Chief Executive Officer
Phone
(706) 213-2536

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X Primary

Addresses

Primary practice location

1029 E Franklin St
Suite D
Hartwell, GA 30643

Mailing address

4 Medical Dr
Elberton, GA 30635-1830
Phone (706) 283-3151

Other names 1

  • HARTWELL FAMILY CLINIC - ELBERT MEMORIAL HOSPITAL Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20240716003025 GA Part A Provider - Rural Health Clinic 6800889841 Practice locations: Hartwell, GA
O20250130000442 GA Part B Supplier - Clinic/Group Practice 6800889841 Receives reassigned benefits from 2 practitioners
Practice locations: Hartwell, GA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1770322117. Details of each certification follow.

Rural health clinic certification: CCN 118587

Legal name
ELBERT MEMORIAL HOSPITAL
Doing business as
HARTWELL FAMILY CLINC
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Sep 8, 2025
Last certification
Sep 8, 2025
Ownership / control type
Non-profit – church related
Organization structure
OtherProprietary
Incorporated
Jun 1, 2024 in GA
Enrollment address
1087 East Franklin Street
Suite D
Hartwell, GA 30643-4535
Related CCNs
111337

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 3

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

National Provider Directory

National Provider Directory
Tax ID family
Lake Russell Specialty5 organizations share this tax ID, including this one
Part of
Lake Russell Specialty

Other organizations with this tax ID 4

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

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

46 Laurel Dr
Elberton, GA 30635
Phone (706) 213-2579

1028 Benson St
Hartwell, GA 30643

1029 E Franklin St
Ste D
Hartwell, GA 30643
Phone (706) 213-3151

1029 E Franklin St
Ste D
Hartwell, GA 30643
Phone (706) 283-3151

1089 E Franklin St
Ste D
Hartwell, GA 30643

1089 E Franklin St
Ste D
Hartwell, GA 30643
Phone (706) 576-7260

Ownership & related parties

All disclosed owners & managing parties 1

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

NameRoleSinceShare
John Taylor Individual Corporate OfficerChief Executive Officer Jun 1, 2024 100%
Operational/Managerial ControlChief Executive Officer Jun 1, 2024 100%

Practitioners & affiliated clinicians

Practitioners 13

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.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1716508800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1737590400000",
    "number": "1770322117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 MEDICAL DR",
            "city": "ELBERTON",
            "state": "GA",
            "postal_code": "306351830",
            "telephone_number": "706-283-3151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1029 E FRANKLIN ST",
            "address_2": "SUITE D",
            "city": "HARTWELL",
            "state": "GA",
            "postal_code": "30643",
            "telephone_number": "706-213-3151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELBERT MEMORIAL HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ELBERTON-ELBERT COUNTY HOSPITAL AUTHORITY",
        "enumeration_date": "2024-05-24",
        "last_updated": "2025-01-23",
        "certification_date": "2025-01-21",
        "status": "A",
        "authorized_official_last_name": "TAYLOR",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "TYLER",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "706-213-2536",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "HARTWELL FAMILY CLINIC - ELBERT MEMORIAL HOSPITAL",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hartwell, GA

Sources for this page

Verify at the official NPI Registry.