Taylor Regional Hospital
Organization Active NPI Rural Health Clinic/Center · Unadilla, GA
NPI 1972852960 · NPPES record last updated Mar 29, 2022
Key facts
- NPI
- 1972852960
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Rural Health Clinic/Center 261QR1300X
- Legal business name
- TAYLOR REGIONAL HOSPITAL
- Practice address
- 2809 Pine St Ste 101
Unadilla, GA 31091-7701 - Phone
- (478) 927-3213
- Fax
- (478) 627-3669
- NPI assigned
- Sep 5, 2012
- Organization subpart
- No
Authorized official
- Name
- Jonathon Green
- Title
- Coo
- Phone
- (478) 783-0200
Other NPIs on the same Medicare enrollment 16
Member of 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040426000736 | GA | Part B Supplier - Clinic/Group Practice | 6800795154 |
Receives reassigned benefits from 23 practitioners 16 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Hawkinsville, GA; Abbeville, GA; Cochran, GA |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | |||
| Rural Health Clinic/Center | 261QR1300X | Yes |
Addresses
Primary practice location
2809 Pine St Ste 101
Unadilla, GA 31091-7701
Mailing address
PO Box 1297
Hawkinsville, GA 31036-7297
Phone (478) 783-0200
Other names
- Taylor Physicians Practice # 24
Other providers in Unadilla, GA
- Dhara Patel
- Vinod Kumar Sachdeva
- Melissa Averett Smith
- Stephen R. Byrd, D.D.S.,P.C.
- Taylor Regional Hospital
- Unadilla Drug Company Inc
- Unadilla Health Care Center Inc
- Unadilla Health Care Center Inc
All providers in Unadilla, GA · Rural Health Clinic/Center in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 29, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.