Organization Active NPI

Hospital Authority of Valdosta and Lowndes County, Georgia

  • Urgent Care Clinic/Center
  • Valdosta, GA
National Provider Identifier
1962886630
Registry record updated Aug 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urgent Care Clinic/CenterTaxonomy code 261QU0200X
License
092141 Issued in GA
Legal business name
HOSPITAL AUTHORITY OF VALDOSTA AND LOWNDES COUNTY, GEORGIA
Practice address
4280 N Valdosta Rd
Valdosta, GA 31602-6814
Phone
(229) 433-8200
Fax
(229) 433-8406
NPI assigned
Jul 13, 2015
Organization subpart
Yes
Parent organization
HOSPITAL AUTHORITY OF VALDOSTA AND LOWNDES COUNTY, GEORGIAAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 22, 2019

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

Authorized official

Name
Mrs. Julie Hodges
Title
Controller
Phone
(229) 259-4140

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urgent Care Clinic/Center 261QU0200X 092141 GA Primary

Addresses

Primary practice location

4280 N Valdosta Rd
Valdosta, GA 31602-6814

Mailing address

PO Box 9
Valdosta, GA 31603-0009
Phone (229) 433-8200

Other names 1

  • SGMC Urgent Care Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040405001313 GA Part B Supplier - Clinic/Group Practice 1355334509 Receives reassigned benefits from 114 practitioners
13 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Valdosta, GA; Nashville, GA; Lakeland, GA

Other NPIs on the same Medicare enrollment 13

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

View all 13

National Provider Directory

National Provider Directory
Part of
Southe Georgia Medical

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1436745600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1566432000000",
    "number": "1962886630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316030009",
            "telephone_number": "229-433-8200",
            "fax_number": "229-433-8406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4280 N VALDOSTA RD",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316026814",
            "telephone_number": "229-433-8200",
            "fax_number": "229-433-8406"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOSPITAL AUTHORITY OF VALDOSTA AND LOWNDES COUNTY, GEORGIA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "HOSPITAL AUTHORITY OF VALDOSTA AND LOWNDES COUNTY, GEORGIA",
        "enumeration_date": "2015-07-13",
        "last_updated": "2019-08-22",
        "status": "A",
        "authorized_official_last_name": "HODGES",
        "authorized_official_first_name": "JULIE",
        "authorized_official_title_or_position": "CONTROLLER",
        "authorized_official_telephone_number": "229-259-4140",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": "GA",
            "license": "092141",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SGMC Urgent Care",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "SGMC Urgent Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Valdosta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2019; 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.