Hillcrest Clinic, LLC
Organization Active NPI Family Medicine Physician · Blairsville, GA
NPI 1831370188 · NPPES record last updated Mar 12, 2025
Key facts
- NPI
- 1831370188
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Medicine Physician 207Q00000X
- Legal business name
- HILLCREST CLINIC, LLC
- Practice address
- 401 Pat Haralson Drive
Unit 1
Blairsville, GA 30512 - Phone
- (706) 745-8790
- NPI assigned
- Nov 15, 2007
- Organization subpart
- No
Authorized official
- Name
- Elizabeth A Maddox
- Title
- Billing
- Phone
- (706) 745-8790
Practitioners 15
-
Matthew C Dyer, PA
-
Victoria Rose Richards, FNP-C
-
Alan M Sanders, MD
-
Tiffany M Rouse, PA-C
-
Jamie Rivkin Blalock, MS, APRN, FNP-C
-
Jaclyn C. Collins, FNP
-
Lesa R Johnson, FNP
-
Kendra Jo Back, ARNP
-
Michael V Owens, APRN
-
Sheila Lynne Whitener, DNP CNM FNP-BC NP-C
-
Dennis Wood, PAC
-
Michael D Folan, NP
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 11D0921540 | Hillcrest Family Care | Certificate of waiver | Mar 13, 2028 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20031120000566 | GA | Part B Supplier - Clinic/Group Practice | 6901700152 |
Receives reassigned benefits from 12 practitioners Practice locations: Blairsville, GA |
National Provider Directory
Locations
401 Pat Haralson Dr
Unit 1
Blairsville, GA 30512
Phone (706) 745-8790
15 Earnest Dr
Blairsville, GA 30512
Phone (706) 745-0200
294 Highway 515 W
Ste L
Blairsville, GA 30512
Phone (706) 745-8790
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | Yes | ||
| Radiology Clinic/Center | 261QR0200X |
Addresses
Primary practice location
401 Pat Haralson Drive
Unit 1
Blairsville, GA 30512
Mailing address
401 Pat Haralson Dr Unit 1
Blairsville, GA 30512-8454
Phone (706) 745-8790
Other practice location 1
15 Earnest Dr
Blairsville, GA 30512-8627
Phone (706) 745-8790
Other names
- HILLCREST CLINIC & IMAGING
- HILLCREST FAMILY CARE
Other providers in Blairsville, GA
- Meghan Nicole Herr
- High Mountain Health, PC
- High Mountain Healthcare, LLC
- Carla Hill
- Kaitlyn Danielle Hill
- Hillside Speech Therapy, LLC
- Ashley Himmel
- Jessie Lane Holbrook
- John William Hollier
- Charles W Holloway
All providers in Blairsville, GA · Family Medicine 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 Mar 12, 2025. 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.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.