NPIMap

Organization Active NPI

Southwest Georgia Healthcare Clinics, Inc

  • Federally Qualified Health Center (FQHC)
  • Donalsonville, GA
National Provider Identifier
1962467217
Registry record updated Aug 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
SOUTHWEST GEORGIA HEALTHCARE CLINICS, INC
Doing business as
Southwest Georgia Healthcare Clinics,inc
Practice address
900 N Wiley Ave
Donalsonville, GA 39845-1127
Phone
(229) 524-8489
Fax
(229) 524-6237
NPI assigned
Apr 19, 2006
Last updated
Aug 11, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
SOUTHWEST GEORGIA HEALTHCARE CLINICS INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 11, 2021

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

Authorized official

Name
James Moody
Title
Cfo
Phone
(229) 524-5217

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207V00000X
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

900 N Wiley Ave
Donalsonville, GA 39845-1127

Mailing address

900 N Wiley Ave
Donalsonville, GA 39845-1127
Phone (229) 524-8489

Other names 2

  • Southwest Georgia Healthcare Clinics,inc Doing business as
  • Southwest Georgia Healthcare Clinics Women's Ctn Former legal business name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170613002024 GA Part B Supplier - Clinic/Group Practice 9739457896 Receives reassigned benefits from 8 practitioners
3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Donalsonville, GA

Other NPIs on the same Medicare enrollment 3

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

National Provider Directory

National Provider Directory
Part of
Southwest Georgia Healthcare Clinics Inc

Practitioners & affiliated clinicians

Practitioners 3

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": "1145404800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1628640000000",
    "number": "1962467217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 N WILEY AVE",
            "city": "DONALSONVILLE",
            "state": "GA",
            "postal_code": "398451127",
            "telephone_number": "229-524-8489",
            "fax_number": "229-524-6237"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 N WILEY AVE",
            "city": "DONALSONVILLE",
            "state": "GA",
            "postal_code": "398451127",
            "telephone_number": "229-524-8489",
            "fax_number": "229-524-6237"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHWEST GEORGIA HEALTHCARE CLINICS, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SOUTHWEST GEORGIA HEALTHCARE CLINICS INC",
        "enumeration_date": "2006-04-19",
        "last_updated": "2021-08-11",
        "certification_date": "2021-08-11",
        "status": "A",
        "authorized_official_last_name": "MOODY",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "229-524-5217"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Southwest Georgia Healthcare Clinics,inc",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Southwest Georgia Healthcare Clinics Women's Ctn",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Southwest Georgia Healthcare Clinics Women's Ctn",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Donalsonville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2021; 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.