Organization Active NPI

Worth County Board of Health

  • Public Health or Welfare Agency
  • Sylvester, GA
National Provider Identifier
1851382816
Registry record updated Oct 23, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Public Health or Welfare AgencyTaxonomy code 251K00000X
Legal business name
WORTH COUNTY BOARD OF HEALTH
Practice address
1012 W Franklin St
Sylvester, GA 31791-1978
Phone
(229) 777-2150
Fax
(229) 777-2170
NPI assigned
Oct 31, 2005
Last updated
Oct 23, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2017

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

Authorized official

Name
Charles D Ruis, MDNPI 1275570715
Title
District Health Director
Phone
(229) 352-4275

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

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

Addresses

Primary practice location

1012 W Franklin St
Sylvester, GA 31791-1978

Mailing address

PO Box 785
Sylvester, GA 31791-0785
Phone (229) 777-2150

Other identifiers 4

IdentifierTypeStateIssuer
00456475NMedicaidGA
00561096AMedicaidGA
00452933NMedicaidGA
00052049PMedicaidGA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20051109000151 GA Part B Supplier - Mass Immunization (Roster Biller Only) 3577581404 Practice locations: Sylvester, GA

National Provider Directory

National Provider Directory

Locations

1012 W Franklin St
Sylvester, GA 31791
Phone (229) 777-2150

1020 W Franklin St
Sylvester, GA 31791
Phone (912) 776-3371

Practitioners & affiliated clinicians

Practitioners 2

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": "1130716800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1508716800000",
    "number": "1851382816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 785",
            "city": "SYLVESTER",
            "state": "GA",
            "postal_code": "317910785",
            "telephone_number": "229-777-2150",
            "fax_number": "229-777-2170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1012 W FRANKLIN ST",
            "city": "SYLVESTER",
            "state": "GA",
            "postal_code": "317911978",
            "telephone_number": "229-777-2150",
            "fax_number": "229-777-2170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WORTH COUNTY BOARD OF HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-31",
        "last_updated": "2017-10-23",
        "status": "A",
        "authorized_official_last_name": "RUIS",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "DISTRICT HEALTH DIRECTOR",
        "authorized_official_telephone_number": "229-352-4275",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": "GA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00456475N",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00561096A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00452933N",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00052049P",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sylvester, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2017; 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.