The Cobb Foundation, Inc.

Primary specialty

Rural Acute Care HospitalTaxonomy code 282NR1301X

License

073-494 Issued in GA

Legal business name

THE COBB FOUNDATION, INC.

Doing business as

Hart County Hospital

Practice address

138 W Gibson St
Hartwell, GA 30643-1847

Phone

(706) 856-6100

Fax

(706) 856-6294

NPI assigned

Sep 7, 2006

Last updated

Aug 4, 2008By 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

Mr. Jerry R Wise

Title

Ceo/Administrator

Phone

(706) 856-6113

Specialties & licenses 1

Addresses

Other identifiers 8

Other names 1

• Hart County Hospital Doing business as

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

{
    "created_epoch": "1157587200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1217808000000",
    "number": "1871696260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 280",
            "city": "HARTWELL",
            "state": "GA",
            "postal_code": "306430280",
            "telephone_number": "706-856-6100",
            "fax_number": "706-856-6117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "138 W GIBSON ST",
            "city": "HARTWELL",
            "state": "GA",
            "postal_code": "306431847",
            "telephone_number": "706-856-6100",
            "fax_number": "706-856-6294"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE COBB FOUNDATION, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-07",
        "last_updated": "2008-08-04",
        "status": "A",
        "authorized_official_last_name": "WISE",
        "authorized_official_first_name": "JERRY",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "CEO/ADMINISTRATOR",
        "authorized_official_telephone_number": "706-856-6113",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "282NR1301X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Rural",
            "state": "GA",
            "license": "073-494",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "207",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01000035",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10455B",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRAIL BLAZER",
            "identifier": "110059B",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "273123",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00000921A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "73076A",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "0606901",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hart County Hospital",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Ting-Yean W. Sullivan, MD
• Troy Sullivan, MD
• T&S Cares LLC
• The Cobb Foundation, Inc (Hartwell Health Care Center)
• The Cobb Foundation, Inc. (Hart County Hospital Swingbed)
• Penny T Thomas
• Tosca Luann Black (Hartwell Eye Associates)
• Total Renal Care Inc (Lake Hartwell Dialysis)
• Janina Vega Rodriguez, PHARMD
• Kennedy Jean Votava

• Rural Acute Care Hospital in Hartwell, GA
• Providers in Hartwell, GA by specialty
• Rural Acute Care Hospital in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.