NPIMap

Organization Active NPI

Gwinnett County Health Department

Doing business as Norcross Health Center

  • Public Health or Welfare Agency
  • Norcross, GA
National Provider Identifier
1912078627
Registry record updated Jun 16, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Public Health or Welfare AgencyTaxonomy code 251K00000X
Legal business name
GWINNETT COUNTY HEALTH DEPARTMENT
Doing business as
Norcross Health Center
Practice address
5030 Georgia Belle CT
Norcross, GA 30093-2667
Phone
(770) 638-5700
NPI assigned
Nov 13, 2006
Last updated
Jun 16, 2008By the provider in NPPES
Organization subpart
Yes
Parent organization
GWINNETT COUNTY HEALTH DEPARTMENTAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 16, 2008

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

Authorized official

Name
Lloyd M Hofer, MD MPHNPI 1568508539
Title
Medical Director
Phone
(770) 339-4260

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 Primary

Addresses

Primary practice location

5030 Georgia Belle CT
Norcross, GA 30093-2667

Mailing address

PO Box 897
Lawrenceville, GA 30046-0897

Other identifiers 6

IdentifierTypeStateIssuer
000051917EMedicaidGA
000452889CMedicaidGA
000456486EMedicaidGA
000058517FMedicaidGA
000456486JMedicaidGA
000956194BMedicaidGA

Other names 1

  • Norcross Health Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20111114000567 GA Part B Supplier - Public Health/Welfare Agency 5799959557 4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Lawrenceville, GA; Snellville, GA; Norcross, GA; Buford, GA

Other NPIs on the same Medicare enrollment 4

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Gwinnett County Health Department7 organizations share this tax ID, including this one
Part of
Gwinnett County Health Department

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1163376000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213574400000",
    "number": "1912078627",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 897",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300460897"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5030 GEORGIA BELLE CT",
            "city": "NORCROSS",
            "state": "GA",
            "postal_code": "300932667",
            "telephone_number": "770-638-5700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GWINNETT COUNTY HEALTH DEPARTMENT",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GWINNETT COUNTY HEALTH DEPARTMENT",
        "enumeration_date": "2006-11-13",
        "last_updated": "2008-06-16",
        "status": "A",
        "authorized_official_last_name": "HOFER",
        "authorized_official_first_name": "LLOYD",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "770-339-4260",
        "authorized_official_credential": "MD MPH"
    },
    "taxonomies": [
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000051917E",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000452889C",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000456486E",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000058517F",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000456486J",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000956194B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Norcross Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Norcross, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2008; 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.