Tri County Medical Center, Inc

Primary specialty

Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X

Legal business name

TRI COUNTY MEDICAL CENTER, INC

Doing business as

Georgiana Medical Clinic

Practice address

138 Jones St
Georgiana, AL 36033-4510

Phone

(334) 376-0078

Fax

(334) 376-0144

NPI assigned

Mar 5, 2007

Last updated

Apr 7, 2008By the provider in NPPES

Organization subpart

Yes

Parent organization

TRI COUNTY MEDICAL CENTER, INCAs reported in NPPES

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

Authorized official

Name

Marilyn J Sawyer

Title

Executive Director

Phone

(251) 578-1163

Specialties & licenses 1

Addresses

Other names 1

• GEORGIANA MEDICAL CLINIC Doing business as

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1831228766. Details of each certification follow.

• CCN 011915 Federally qualified health center · Active · Name & address match · Details

Federally qualified health center certification: CCN 011915

Legal name

GEORGIANA MEDICAL CENTER

Certification status

Active

Provider type (POS)

Federally qualified health center

Participating since

Dec 10, 2001

Last certification

Dec 10, 2001

Ownership / control type

For profit – corporation

Facility address

138 West Jones Street
Georgiana, AL 36033

Part of

Tri-County Med Ctr Inc

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Tri County Medical Center Inc

  • Internal Medicine Physician
  • Evergreen, AL
  • NPI 1679658371
  NPPES parent name

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

{
    "created_epoch": "1173052800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1207526400000",
    "number": "1831228766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 726",
            "city": "EVERGREEN",
            "state": "AL",
            "postal_code": "364010726",
            "telephone_number": "251-578-1163",
            "fax_number": "251-578-6963"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "138 JONES ST",
            "city": "GEORGIANA",
            "state": "AL",
            "postal_code": "360334510",
            "telephone_number": "334-376-0078",
            "fax_number": "334-376-0144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRI COUNTY MEDICAL CENTER, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "TRI COUNTY MEDICAL CENTER, INC",
        "enumeration_date": "2007-03-05",
        "last_updated": "2008-04-07",
        "status": "A",
        "authorized_official_last_name": "SAWYER",
        "authorized_official_first_name": "MARILYN",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "251-578-1163"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "GEORGIANA MEDICAL CLINIC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• South Butler Medical Services LLC (ReliableHospice Services)
• Southern Express Medical Supply, Inc
• State of Alabama Department of Public Health (Butler County Health Dept Flu-Pneu)
• The Health Care Authority of the City of Greenville (Regional Medical Center Clinics)
• The Health Care Authority of the City of Greenville (Regional Medical Center Clinics)
• Jeffrey Dean Voreis, MD
• Holley Arnold Waller, M.S., CCC-SLP
• Chastity Waters
• Rachel Wiggins, CRNP
• Evelyn S Williamson, CRNA

• Federally Qualified Health Center (FQHC) in Georgiana, AL
• Providers in Georgiana, AL by specialty
• Federally Qualified Health Center (FQHC) in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.