NPIMap

Organization Active NPI

Archbold Medical Group

Doing business as Archbold Brooks Specialty Clinic

  • Multi-Specialty Clinic/Center
  • Quitman, GA
National Provider Identifier
1912335308
Registry record updated Oct 22, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
ARCHBOLD MEDICAL GROUP
Doing business as
Archbold Brooks Specialty Clinic
Practice address
1309 W Screven St
Quitman, GA 31643-1819
Phone
(229) 227-5158
NPI assigned
Oct 22, 2013
Last updated
Oct 22, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2013

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

Authorized official

Name
Charles Hightower
Title
Cfo
Phone
(229) 228-2853

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X Primary

Addresses

Primary practice location

1309 W Screven St
Quitman, GA 31643-1819

Mailing address

900 Cairo Rd
Thomasville, GA 31792-4255

Other names 1

  • Archbold Brooks Specialty Clinic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20081001000632 GA Part B Supplier - Clinic/Group Practice 8123196383 Receives reassigned benefits from 103 practitioners
4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Thomasville, GA; Whigham, GA; Bainbridge, GA; Cairo, GA; Camilla, GA; Moultrie, GA; Pelham, GA; Quitman, 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
Archbold Medical Group Inc14 organizations share this tax ID, including this one

Other organizations with this tax ID 13

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

View all 13

Locations

704 S Broad St
Thomasville, GA 31792
Phone (229) 226-8880

Practitioners & affiliated clinicians

Practitioners 5

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": "1382400000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1382400000000",
    "number": "1912335308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 CAIRO RD",
            "city": "THOMASVILLE",
            "state": "GA",
            "postal_code": "317924255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1309 W SCREVEN ST",
            "city": "QUITMAN",
            "state": "GA",
            "postal_code": "316431819",
            "telephone_number": "229-227-5158"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ARCHBOLD MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-10-22",
        "last_updated": "2013-10-22",
        "status": "A",
        "authorized_official_last_name": "HIGHTOWER",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "229-228-2853"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Archbold Brooks Specialty Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Quitman, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2013; 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.