Burke Hospital Company
Organization Active NPI Multi-Specialty Clinic/Center · Waynesboro, GA
NPI 1861134546 · NPPES record last updated Oct 3, 2022
Key facts
- NPI
- 1861134546
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Multi-Specialty Clinic/Center 261QM1300X
- Legal business name
- BURKE HOSPITAL COMPANY
- Practice address
- 411 W 4TH St
Waynesboro, GA 30830-1511 - Phone
- (706) 702-2667
- Fax
- (706) 262-2988
- NPI assigned
- Apr 12, 2022
- Organization subpart
- Yes
- Parent organization (as reported)
- BURKE HOSPITAL COMPANY
Authorized official
- Name
- Michael S Hester
- Title
- Ceo
- Phone
- (912) 369-9400
Other NPIs on the same Medicare enrollment 13
Corporate family (same tax ID) 17
Practitioners 3
-
Ashley J Boynton, NP-C
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20220411001540 | GA | Part B Supplier - Clinic/Group Practice | 3476956012 |
Receives reassigned benefits from 18 practitioners 13 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Springfield, GA; Waynesboro, GA; Thomson, GA; Swainsboro, GA; Statesboro, GA; Sandersville, GA; Millen, GA; Louisville, GA |
National Provider Directory
- Tax ID family
- Burke Hospital Company
- Part of
- Burke Hospital Company
Locations
1067 Peachtree St
Louisville, GA 30434
Phone (478) 625-7000
411 W 4th St
Waynesboro, GA 30830
Phone (706) 437-2690
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Multi-Specialty Clinic/Center | 261QM1300X | Yes |
Addresses
Primary practice location
411 W 4TH St
Waynesboro, GA 30830-1511
Mailing address
351 S Liberty St
Waynesboro, GA 30830-9686
Phone (706) 554-4435
Other names
- Burke Cardiology
Other providers in Waynesboro, GA
- Burke Hospital Company
- Burke Hospital Company
- Burke Hospital Company
- Burke Hospital Company
- Burke Hospital Company
- Burke Hospital Company
- Victoria Antoinette Burley
- Brandy L Bushatz
- Joshua Cain Sr.
- Tori Calia
All providers in Waynesboro, GA · Multi-Specialty Clinic/Center in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 3, 2022. 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.