NPIMap

Organization Active NPI

Abraham Baldwin Agricultural College

  • Student Health Clinic/Center
  • Tifton, GA
National Provider Identifier
1891038568
Registry record updated Apr 1, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student Health Clinic/CenterTaxonomy code 261QS1000X
Legal business name
ABRAHAM BALDWIN AGRICULTURAL COLLEGE
Practice address
2802 Moore Hwy
Abac 52
Tifton, GA 31793-5679
Phone
(229) 391-5030
Fax
(229) 391-5031
NPI assigned
Apr 1, 2013
Last updated
Apr 1, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2013

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

Authorized official

Name
John Clemens
Title
VP Planning & Operations
Phone
(229) 391-4875

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student Health Clinic/Center 261QS1000X Primary

Addresses

Primary practice location

2802 Moore Hwy
Abac 52
Tifton, GA 31793-5679

Mailing address

2802 Moore Hwy
Abac 52
Tifton, GA 31793-5679
Phone (229) 391-5030

Other names 1

  • ABAC Student Health Services Other name

National Provider Directory

National Provider Directory

Locations

2802 Moore Hwy
#52
Tifton, GA 31793
Phone (229) 391-5030

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": "1364774400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1364774400000",
    "number": "1891038568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2802 MOORE HWY",
            "address_2": "ABAC 52",
            "city": "TIFTON",
            "state": "GA",
            "postal_code": "317935679",
            "telephone_number": "229-391-5030",
            "fax_number": "229-391-5031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2802 MOORE HWY",
            "address_2": "ABAC 52",
            "city": "TIFTON",
            "state": "GA",
            "postal_code": "317935679",
            "telephone_number": "229-391-5030",
            "fax_number": "229-391-5031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ABRAHAM BALDWIN AGRICULTURAL COLLEGE",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-04-01",
        "last_updated": "2013-04-01",
        "status": "A",
        "authorized_official_last_name": "CLEMENS",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "VP PLANNING & OPERATIONS",
        "authorized_official_telephone_number": "229-391-4875"
    },
    "taxonomies": [
        {
            "code": "261QS1000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Student Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ABAC Student Health Services",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Tifton, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2013; 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.