Polk County Board of Health

Primary specialty

Public Health or Welfare AgencyTaxonomy code 251K00000X

License

025271 Issued in GA

Legal business name

POLK COUNTY BOARD OF HEALTH

Practice address

320 Water St
Rockmart, GA 30153-2669

Phone

(770) 684-1385

Fax

(770) 684-8231

NPI assigned

Oct 12, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

C. Wade Sellers, M.D.

Title

District Health Director

Phone

(706) 295-6704

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

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

• Polk County Board of Health

  • Public Health or Welfare Agency
  • Cedartown, GA
  • NPI 1710087960

  O20100420000579

  Same enrollment

Tax ID family

Polk County Board of Health3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

• Polk County Board of Health

  dba Polk Primary Care Clinic

  • Public Health or Welfare Agency
  • Cedartown, GA
  • NPI 1093944423
  NPD tax ID
• Polk County Board of Health

  • Public Health or Welfare Agency
  • Cedartown, GA
  • NPI 1710087960
  NPD tax ID

Locations

Practitioners 3

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.

• Amy Tillmann Norris

  • Family Nurse Practitioner
  • Cedartown, GA
  • NPI 1093662264
  NPD (past)
• Hannah M O'Kelley, LD

  • Registered Dietitian
  • Ringgold, GA
  • NPI 1659522530
  NPD (past)
• Brittany Shereece Sublett, FNP-BC

  • Nurse Practitioner
  • Rome, GA
  • NPI 1811694342
  NPD (past)

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1831288679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 WATER ST",
            "city": "ROCKMART",
            "state": "GA",
            "postal_code": "301532669",
            "telephone_number": "770-684-1385",
            "fax_number": "770-684-8231"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 WATER ST",
            "city": "ROCKMART",
            "state": "GA",
            "postal_code": "301532669",
            "telephone_number": "770-684-1385",
            "fax_number": "770-684-8231"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POLK COUNTY BOARD OF HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-12",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SELLERS",
        "authorized_official_first_name": "C. WADE",
        "authorized_official_title_or_position": "DISTRICT HEALTH DIRECTOR",
        "authorized_official_telephone_number": "706-295-6704",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": "GA",
            "license": "025271",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jacob Roy Parker, DO
• Alpita Patel
• Patriot Emergency Medical Services LLC
• Renee Payne, RPSGT, CCSH
• Courtney G Pinson, PTA
• Chelsea Smith Pruitt
• Puckett Senior Care Solutions, LLC
• Pierre O Raymond Sr.
• Redmond Physician Practice Company (Redmond Family Care at Rockmart)
• Franklin Reeves

• Public Health or Welfare Agency in Rockmart, GA
• Providers in Rockmart, GA by specialty
• Public Health or Welfare Agency in Georgia

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