NPIMap

Organization Active NPI

Albany Area Primary Health Care, Inc.

Doing business as East Albany Medical Center

  • Federally Qualified Health Center (FQHC)
  • Albany, GA
National Provider Identifier
1780608992
Registry record updated Jul 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
ALBANY AREA PRIMARY HEALTH CARE, INC.
Doing business as
East Albany Medical Center
Practice address
1712-A East Broad Avenue
Albany, GA 31705
Phone
(229) 639-3100
Fax
(229) 888-6516
NPI assigned
Jul 27, 2006
Last updated
Jul 1, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2025

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

Authorized official

Name
Shelley Spires
Title
Ceo
Phone
(229) 888-6559

Specialties & licenses 1

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

Addresses

Primary practice location

1712-A East Broad Avenue
Albany, GA 31705

Mailing address

2408 Westgate Dr
Albany, GA 31707-2277
Phone (229) 888-6559

Other identifiers 1

IdentifierTypeStateIssuer
489701989AMedicaidGA

Other names 1

  • East Albany Medical Center Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040217000509 GA Part B Supplier - Clinic/Group Practice 7911811922 Receives reassigned benefits from 129 practitioners
34 other NPIs on this enrollment
Practice locations: Albany, GA; Americus, GA; Camilla, GA; Cordele, GA; Dawson, GA; Edison, GA; Fort Gaines, GA; Leesburg, GA…
O20041028000722 GA Part A Provider - Federally Qualified Health Center (FQHC) 7911811922 Practice locations: Albany, GA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1780608992. Details of each certification follow.

Federally qualified health center certification: CCN 111886

Legal name
ALBANY AREA PRIMARY HEALTH CARE, INC
Doing business as
EAST ALBANY MEDICAL CENTER
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Nov 4, 2004
Last certification
Nov 4, 2004
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Nov 29, 1979 in GA
Enrollment address
1712-A E. Broad Avenue
Albany, GA 31705-2611

Other NPIs on the same Medicare enrollment 34

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

View all 34

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
11D0265849East Albany Medical Center1712-A East Broad Avenue, Albany, GA 31705Provider-performed microscopyNov 3, 2027

National Provider Directory

National Provider Directory

Locations

1712 E Broad Ave
Albany, GA 31705
Phone (229) 639-3103

2410 Sylvester Hwy
Albany, GA 31705
Phone (229) 312-9200

Ownership & related parties

All disclosed owners & managing parties 12

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

NameRoleSinceShare
Elizabeth J West Individual Corporate DirectorBoard Member May 1, 1998
Brad R Stafford Individual Corporate DirectorBoard Vice President Jan 1, 2006
Christopher L Jones Individual Corporate DirectorBoard Secretary Apr 1, 2011
Brenda C Williams Individual Corporate DirectorBoard Member Nov 1, 1992
Kuanita Murphy Individual Corporate DirectorBoard Member Sep 1, 2011
Victoria Darrisaw Individual Corporate DirectorBoard Member May 1, 2013
Adolphus Major Individual Corporate DirectorBoard Member Dec 1, 2015
Steven E Kitchen Individual Corporate DirectorBoard Member Apr 1, 2015
Sybil L Thomas Individual Corporate DirectorBoard Member Dec 1, 2007
Jimmy D Quinn Individual Corporate DirectorBoard President Jul 1, 2008
Shelley Spires Individual Corporate OfficerCeo Sep 4, 2015
W-2 Managing EmployeeCeo Sep 4, 2015
Douglas W Patten Individual Corporate DirectorBoard Member Dec 1, 2008

All facility ownership & control disclosures 18

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

FacilityTypeRoleSince
Mirian Worthy Women's Health CenterAlbany, GA, CCN 111922 Federally qualified health center Operational/Managerial Control (100%) Nov 29, 1979
West Albany Dental & Medical CenterAlbany, GA, CCN 111940 Federally qualified health center Operational/Managerial Control Jun 14, 2011
S.Trussell Medical CenterVienna, GA, CCN 111941 Federally qualified health center Operational/Managerial Control (100%) Jun 1, 2010
Rural HIV Model ThomasvilleThomasville, GA, CCN 111965 Federally qualified health center Operational/Managerial Control (100%) Nov 29, 1979
Alice Coachman Elementary School-Based Health CenterAlbany, GA, CCN 111025 Federally qualified health center Operational/Managerial Control (100%) Nov 29, 1979
Albany Middle School-Based Health CenterAlbany, GA, CCN 111023 Federally qualified health center Operational/Managerial Control (100%) Nov 29, 1979
Dooly County School-Based Health CenterPinehurst, GA, CCN 111032 Federally qualified health center Operational/Managerial Control (100%) Nov 29, 1979
Aaphc Renaissance CenterAlbany, GA, CCN 111033 Federally qualified health center Operational/Managerial Control (100%) Nov 29, 1979
Terrell County School-Based Health CenterDawson, GA, CCN 111034 Federally qualified health center Operational/Managerial Control (100%) Nov 29, 1979
Hotz Scoggins Family Medical CenterAlbany, GA, CCN 111036 Federally qualified health center Operational/Managerial Control (100%) Nov 29, 1979
Robert Harvey Elementary School-Based Health CenterAlbany, GA, CCN 111083 Federally qualified health center Operational/Managerial Control (100%) Nov 29, 1979
Live Oak Elementary School-Based Health CenterAlbany, GA, CCN 111081 Federally qualified health center Operational/Managerial Control (100%) Nov 29, 1979
Aaphc Americus Behavioral Wellness CenterAmericus, GA, CCN 851166 Federally qualified health center Operational/Managerial Control (100%) Nov 29, 1979
Mitchell County School-Based Health CenterCamilla, GA, CCN 851167 Federally qualified health center Operational/Managerial Control (100%) Nov 29, 1979
Albany Area PediatricsAlbany, GA, CCN 851174 Federally qualified health center Operational/Managerial Control (100%) Nov 29, 1979
Aaphc Elois Edge Women's Health CenterAlbany, GA, CCN 111155 Federally qualified health center Operational/Managerial Control (100%) Nov 29, 1979
Albany Area Primary Health Care, IncFort Gaines, GA, CCN 851965 Federally qualified health center Operational/Managerial Control (100%) Nov 29, 1979
Albany Area Primary Health Care, IncAmericus, GA, CCN 851967 Federally qualified health center Operational/Managerial Control (100%) Nov 29, 1979

Practitioners & affiliated clinicians

Practitioners 133

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 133

NPI Registry JSON

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

{
    "created_epoch": "1153958400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1751328000000",
    "number": "1780608992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2408 WESTGATE DR",
            "city": "ALBANY",
            "state": "GA",
            "postal_code": "317072277",
            "telephone_number": "229-888-6559",
            "fax_number": "229-436-4107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1712-A EAST BROAD AVENUE",
            "city": "ALBANY",
            "state": "GA",
            "postal_code": "31705",
            "telephone_number": "229-639-3100",
            "fax_number": "229-888-6516"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALBANY AREA PRIMARY HEALTH CARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-27",
        "last_updated": "2025-07-01",
        "certification_date": "2025-07-01",
        "status": "A",
        "authorized_official_last_name": "SPIRES",
        "authorized_official_first_name": "SHELLEY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "229-888-6559"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "489701989A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "East Albany Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Albany, GA

Sources for this page

Verify at the official NPI Registry.