Southern Health Corp of Ellijay

Primary specialty

Rural Acute Care HospitalTaxonomy code 282NR1301X

License

061435 Issued in GA

Legal business name

SOUTHERN HEALTH CORP OF ELLIJAY

Practice address

1362 S Main St
822 Industrial Blvd; 60 Old Highway 5 South
Ellijay, GA 30540-5410

Phone

(706) 276-4741

Fax

(706) 276-4645

NPI assigned

Sep 5, 2005

Organization subpart

No

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

Authorized official

Name

Ms. Debbie Ann Self

Title

Chief Financial Officer

Phone

(706) 276-4741

Specialties & licenses 1

Addresses

Other identifiers 6

Other names 1

• North Georgia Medical Center Doing business as

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kelvin Jerry Moss, M.D.

  • Hospitalist Physician
  • Dalton, GA
  • NPI 1275640526
  NPD
• Nadine American Thomas, M.D.

  • Pediatric Adolescent Medicine Physician
  • East Ellijay, GA
  • NPI 1265532808
  NPD

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

{
    "created_epoch": "1125878400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1371168000000",
    "number": "1952395097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2239",
            "address_2": "PO BOX 1019",
            "city": "ELLIJAY",
            "state": "GA",
            "postal_code": "305400025",
            "telephone_number": "706-276-4741",
            "fax_number": "706-276-4645"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1362 S MAIN ST",
            "address_2": "822 INDUSTRIAL BLVD; 60 OLD HIGHWAY 5 SOUTH",
            "city": "ELLIJAY",
            "state": "GA",
            "postal_code": "305405410",
            "telephone_number": "706-276-4741",
            "fax_number": "706-276-4645"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN HEALTH CORP OF ELLIJAY",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-05",
        "last_updated": "2013-06-14",
        "status": "A",
        "authorized_official_last_name": "SELF",
        "authorized_official_first_name": "DEBBIE",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "706-276-4741",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "282NR1301X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Rural",
            "state": "GA",
            "license": "061435",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HAROLD M WATKINS NPI",
            "identifier": "1255369005",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "APPLE MEDICAL CENTER",
            "identifier": "1952395097",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00002043A",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI BRIAN A ROWAN",
            "identifier": "1821059510",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SHANNON PITMAN NPI NUMBER",
            "identifier": "1982773891",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NORTH GEORGIA FAMILY PRACTICE",
            "identifier": "1952395097",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "North Georgia Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Southern Health Corp of Ellijay
• Southern Health Corp of Ellijay
• Southern Health Corp of Ellijay
• Southern Health Corp of Ellijay
• Southern Health Corp of Ellijay
• Southland Health Services of Georgia, Inc.
• Linda Jeannette Stanley, LMT
• Donna Greene Sweat, FNP-C
• Talbot Dental Associates PC
• Travis Tarleton

• Rural Acute Care Hospital in Ellijay, GA
• Providers in Ellijay, 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 Jun 14, 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.