Active NPI
Evans County Board of Health
- Public Health or Welfare Agency
- Claxton, GA
National Provider Identifier
1922037209
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Public Health or Welfare Agency
- Legal business name
- EVANS COUNTY BOARD OF HEALTH
- Practice address
- 4 N Newton St
Claxton, GA 30417-1756 - Phone
- (912) 739-2088
- Fax
- (912) 739-3975
- NPI assigned
- Jun 30, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Starla Sutton
- Title
- Pso
- Phone
- (912) 427-2042
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Public Health or Welfare Agency | 251K00000X | Primary |
Addresses
Primary practice location
4 N Newton St
Claxton, GA 30417-1756
Mailing address
PO Box 366
Claxton, GA 30417-0366
Phone (912) 739-2088
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000442967L | Medicaid | GA | |
| 000052027K | Medicaid | GA | |
| 000777279A | Medicaid | GA | |
| 000457784L | Medicaid | GA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20130529000698 | GA | Part B Supplier - Mass Immunization (Roster Biller Only) | 2961496567 | Practice locations: Claxton, GA |
National Provider Directory
National Provider DirectoryLocations
4 N Newton St
Claxton, GA 30417
Phone (912) 739-2088
Practitioners & affiliated clinicians
Practitioners 5
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Nurse Practitioner
- Jesup, GA
- NPI 1043242894
-
- Registered Dietitian
- Evans, GA
- NPI 1760491575
-
- Internal Medicine Physician
- Waycross, GA
- NPI 1821005554
-
- Registered Nurse
- Claxton, GA
- NPI 1376464883
-
- Nurse Practitioner
- Statesboro, GA
- NPI 1528092897
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151625600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1303862400000",
"number": "1922037209",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 366",
"city": "CLAXTON",
"state": "GA",
"postal_code": "304170366",
"telephone_number": "912-739-2088",
"fax_number": "912-739-3975"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4 N NEWTON ST",
"city": "CLAXTON",
"state": "GA",
"postal_code": "304171756",
"telephone_number": "912-739-2088",
"fax_number": "912-739-3975"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "EVANS COUNTY BOARD OF HEALTH",
"organizational_subpart": "NO",
"enumeration_date": "2006-06-30",
"last_updated": "2011-04-27",
"status": "A",
"authorized_official_last_name": "SUTTON",
"authorized_official_first_name": "STARLA",
"authorized_official_title_or_position": "PSO",
"authorized_official_telephone_number": "912-427-2042"
},
"taxonomies": [
{
"code": "251K00000X",
"taxonomy_group": "",
"desc": "Public Health or Welfare",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "000442967L",
"state": "GA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "000052027K",
"state": "GA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "000777279A",
"state": "GA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "000457784L",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Claxton, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2011; 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.