Jenkins County Hospital LLC
Organization Active NPI Orthopaedic Surgery Physician · Sylvania, GA
NPI 1811264625 · NPPES record last updated Jan 10, 2012
Key facts
- NPI
- 1811264625
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Orthopaedic Surgery Physician 207X00000X
- Legal business name
- JENKINS COUNTY HOSPITAL LLC
- Practice address
- 209A Mims Rd
Sylvania, GA 30467-1994 - Phone
- (800) 827-6536
- NPI assigned
- Nov 22, 2011
- Organization subpart
- No
Authorized official
- Name
- Michael W Kleinpeter
- Title
- Ceo
- Phone
- (912) 644-5300
Other NPIs on the same Medicare enrollment 10
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20110126000836 | GA | Part B Supplier - Clinic/Group Practice | 0143419820 |
Receives reassigned benefits from 5 practitioners 10 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Millen, GA |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopaedic Surgery Physician |
207X00000X | Yes |
Addresses
Primary practice location
209A Mims Rd
Sylvania, GA 30467-1994
Mailing address
210 E Derenne Ave
Savannah, GA 31405-6736
Phone (912) 644-5300
Other names
- Optim Medical Center - Jenkins
Other providers in Sylvania, GA
- Margaret Ann Hollingsworth
- Valarie Hopkins
- Miranda Jackson
- Sharon A. Jacobs
- Mary Lana Jarrell
- Jenkins County Hospital, LLC
- Latrell Jenkins
- Courtney Johnson
- Mary Beth Jones-Godbee
- William Kent
All providers in Sylvania, GA · Orthopaedic Surgery Physician in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 10, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.