Camden County Commissioner of

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

CAMDEN COUNTY COMMISSIONER OF

Practice address

701 Charles Gilman Jr Ave
Suite B
Kingsland, GA 31548-5661

Phone

(912) 729-8942

Fax

(912) 729-1059

NPI assigned

Aug 22, 2014

Last updated

Oct 5, 2023By 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

Mrs. Cynthia R Popa, RN

Title

Clinic Director

Phone

(912) 729-8942

Specialties & licenses 1

Addresses

Other names 1

• Living Well Onsite Wellness Clinic Other name

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Other NPIs with the same Medicare PAC ID 1

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

• Camden County Commissioner of

  dba Camden County Fire Rescue

  • Land Ambulance
  • Kingsland, GA
  • NPI 1093782732

  2466420443

  Same PAC ID

Tax ID family

Camden County Fire Resc2 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.

• Camden County Commissioner of

  dba Camden County Fire Rescue

  • Land Ambulance
  • Kingsland, GA
  • NPI 1093782732
  NPD tax ID

Locations

Practitioners 1

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.

• Melissa Anne White, ARNP-BC

  • Primary Care Nurse Practitioner
  • Kingsland, GA
  • NPI 1053649657
  Medicare reassignment NPD

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

{
    "created_epoch": "1408665600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1696464000000",
    "number": "1831598135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 CHARLES GILMAN JR AVE",
            "address_2": "SUITE B",
            "city": "KINGSLAND",
            "state": "GA",
            "postal_code": "315485661",
            "telephone_number": "912-729-8942",
            "fax_number": "912-729-1059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 CHARLES GILMAN JR AVE",
            "address_2": "SUITE B",
            "city": "KINGSLAND",
            "state": "GA",
            "postal_code": "315485661",
            "telephone_number": "912-729-8942",
            "fax_number": "912-729-1059"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAMDEN COUNTY COMMISSIONER OF",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-08-22",
        "last_updated": "2023-10-05",
        "certification_date": "2023-10-05",
        "status": "A",
        "authorized_official_last_name": "POPA",
        "authorized_official_first_name": "CYNTHIA",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "CLINIC DIRECTOR",
        "authorized_official_telephone_number": "912-729-8942",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Living Well Onsite Wellness Clinic",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Living Well Onsite Wellness Clinic",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Camcoast Services Inc
• Camden C & a
• Camden County Board of Health (Camden County Health Department)
• Camden County Board of Health (Camden County Health Department)
• Camden County Commissioner of (Camden County Fire Rescue)
• Camden County Schools
• Camden Health and Wellness PC
• Camden Healthcare Associates, Inc.
• Camden Urgent Care and Wellness Center
• Camden Women's Center

• Clinic/Center in Kingsland, GA
• Providers in Kingsland, GA by specialty
• Clinic/Center in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2023; 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.