NPIMap

Organization Active NPI

Northeast Georgia Medical Center, Inc.

  • Land Ambulance
  • Gainesville, GA
National Provider Identifier
1790721942
Registry record updated Apr 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Land AmbulanceTaxonomy code 3416L0300X
Legal business name
NORTHEAST GEORGIA MEDICAL CENTER, INC.
Practice address
675 White Sulphur Rd
Suite 285
Gainesville, GA 30501-8921
Phone
(770) 219-8899
Fax
(770) 219-8898
NPI assigned
Jun 22, 2006
Organization subpart
Yes
Parent organization
NORTHEAST GEORGIA MEDICAL CENTER, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 22, 2020

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

Authorized official

Name
Brian D Steines
Title
Cfo
Phone
(770) 219-3562

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Land Ambulance 3416L0300X Primary

Addresses

Primary practice location

675 White Sulphur Rd
Suite 285
Gainesville, GA 30501-8921

Mailing address

743 Spring St NE
Gainesville, GA 30501-3715
Phone (770) 219-9000

Other identifiers 1

IdentifierTypeStateIssuer
00310362BMedicaidGA

Other names 1

  • ERS/LIFELINE Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Northeast Ga Med Center11 organizations share this tax ID, including this one
Part of
Northeast Ga Med Center

Other organizations with this tax ID 10

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

Locations

675 White Sulphur Rd
Ste 285
Gainesville, GA 30501
Phone (770) 219-8899

NPI Registry JSON

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

{
    "created_epoch": "1150934400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1587513600000",
    "number": "1790721942",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "743 SPRING ST NE",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305013715",
            "telephone_number": "770-219-9000",
            "fax_number": "770-219-6694"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "675 WHITE SULPHUR RD",
            "address_2": "SUITE 285",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305018921",
            "telephone_number": "770-219-8899",
            "fax_number": "770-219-8898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHEAST GEORGIA MEDICAL CENTER, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NORTHEAST GEORGIA MEDICAL CENTER, INC.",
        "enumeration_date": "2006-06-22",
        "last_updated": "2020-04-22",
        "certification_date": "2020-04-22",
        "status": "A",
        "authorized_official_last_name": "STEINES",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "770-219-3562"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00310362B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ERS/LIFELINE",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "ERS/LIFELINE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Gainesville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2020; 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.