NPIMap

Organization Active NPI

Toombs County Wellness Center

  • Public Health or Welfare Agency
  • Lyons, GA
National Provider Identifier
1831112879
Registry record updated Oct 1, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Public Health or Welfare AgencyTaxonomy code 251K00000X
Legal business name
TOOMBS COUNTY WELLNESS CENTER
Practice address
714 NW Broad Street
Lyons, GA 30436-0308
Phone
(912) 526-9581
Fax
(912) 526-9583
NPI assigned
Jul 25, 2006
Last updated
Oct 1, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2007

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

Authorized official

Name
Starla Sutton
Title
Pso
Phone
(912) 338-5263

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Public Health or Welfare Agency 251K00000X NU Primary

Addresses

Primary practice location

714 NW Broad Street
Lyons, GA 30436-0308

Mailing address

PO Box 308
Lyons, GA 30436-0308
Phone (912) 526-9581

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040504000055 GA Part B Supplier - Clinic/Group Practice 4183612732 Receives reassigned benefits from 8 practitioners
Practice locations: Lyons, GA

Other NPIs with the same Medicare PAC ID 1

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

National Provider Directory

National Provider Directory
Tax ID family
Just Teens Clinic2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

714 NW Broad St
Lyons, GA 30436
Phone (912) 526-8108

Practitioners & affiliated clinicians

Practitioners 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1191196800000",
    "number": "1831112879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 308",
            "city": "LYONS",
            "state": "GA",
            "postal_code": "304360308",
            "telephone_number": "912-526-9581",
            "fax_number": "912-526-9583"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "714 NW BROAD STREET",
            "city": "LYONS",
            "state": "GA",
            "postal_code": "304360308",
            "telephone_number": "912-526-9581",
            "fax_number": "912-526-9583"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TOOMBS COUNTY WELLNESS CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-25",
        "last_updated": "2007-10-01",
        "status": "A",
        "authorized_official_last_name": "SUTTON",
        "authorized_official_first_name": "STARLA",
        "authorized_official_title_or_position": "PSO",
        "authorized_official_telephone_number": "912-338-5263"
    },
    "taxonomies": [
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lyons, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2007; 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.