NPIMap

Organization Active NPI

The Family Health Centers of Georgia, Inc

Doing business as McDonough Children's Specialist

  • Federally Qualified Health Center (FQHC)
  • McDonough, GA
National Provider Identifier
1982489555
Registry record updated Sep 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
THE FAMILY HEALTH CENTERS OF GEORGIA, INC
Doing business as
McDonough Children's Specialist
Practice address
350 Huntington Place CT
McDonough, GA 30253-8651
Phone
(770) 957-3393
NPI assigned
Aug 30, 2023
Last updated
Sep 6, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
THE FAMILY HEALTH CENTERS OF GEORGIA, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 6, 2023

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

Authorized official

Name
Dr. Michael W Brooks, MDNPI 1174513089
Title
Ceo
Phone
(404) 752-1400

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

350 Huntington Place CT
McDonough, GA 30253-8651

Mailing address

868 York Ave SW
Atlanta, GA 30310-2750
Phone (404) 752-1400

Other names 1

  • McDonough Children's Specialist Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250218001883 GA Part A Provider - Federally Qualified Health Center (FQHC) 2062406903 Practice locations: McDonough, GA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1982489555. Details of each certification follow.

Federally qualified health center certification: CCN C21031

Legal name
THE FAMILY HEALTH CENTERS OF GEORGIA, INC
Doing business as
MCDONOUGH CHILDREN'S SPECIALIST
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jan 29, 2025
Last certification
Jan 29, 2025
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Sep 17, 1972 in GA
Enrollment address
350 Huntington Place CT
McDonough, GA 30253-8651

Other NPIs with the same Medicare PAC ID 4

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
University Community He14 organizations share this tax ID, including this one
Part of
University Community He

Other organizations with this tax ID 13

Organizations that report the same tax identification number in the National Provider Directory.

View all 13

Locations

805 Campbell Hill St NW
Marietta, GA 30060
Phone (770) 919-0025

19 John Maddox Dr NW
Ste B
Rome, GA 30165

19 John Maddox Dr NW
Ste Bc
Rome, GA 30165

Ownership & related parties

All disclosed owners & managing parties 13

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Stephanie Smith Individual Corporate DirectorBoard Member Jan 1, 2022
Michael W Brooks Individual Corporate OfficerCeo Jun 1, 2009
W-2 Managing Employee Jun 1, 2009
Tracy E Dillon Individual Corporate DirectorBoard Member Jan 1, 2019
Jan J Williams Individual Corporate DirectorBoard Member Jan 1, 2023
Uwonda Carter Individual Corporate DirectorBoard Member Jan 1, 2023
Matthew Worthy Individual Corporate DirectorBoard Member Jan 1, 2024
Sanquinetta Maria Dover Individual Corporate DirectorBoard Member Jan 1, 2024
Rita Gibson Individual Corporate DirectorBoard Member Jan 1, 2019
Donna Lynne Hubbard Individual Corporate DirectorBoard Member Jan 1, 2020
Lamont Pierre McIntosh Individual Corporate DirectorBoard Member Jan 1, 2021
Janice S Andrews Individual Corporate DirectorBoard Member Jan 1, 2023
Michael Taylor Individual Corporate DirectorBoard Member Jan 1, 2024
Reginald Mebane Individual Corporate DirectorBoard Member Jan 1, 2021

Owners & managing parties with NPI records 2

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Practitioners & affiliated clinicians

Practitioners 38

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.

View all 38

NPI Registry JSON

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

{
    "created_epoch": "1693353600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1693958400000",
    "number": "1982489555",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "868 YORK AVE SW",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303102750",
            "telephone_number": "404-752-1400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 HUNTINGTON PLACE CT",
            "city": "MCDONOUGH",
            "state": "GA",
            "postal_code": "302538651",
            "telephone_number": "770-957-3393"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE FAMILY HEALTH CENTERS OF GEORGIA, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "THE FAMILY HEALTH CENTERS OF GEORGIA, INC",
        "enumeration_date": "2023-08-30",
        "last_updated": "2023-09-06",
        "certification_date": "2023-09-06",
        "status": "A",
        "authorized_official_last_name": "BROOKS",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "404-752-1400",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "McDonough Children's Specialist",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in McDonough, GA

Sources for this page

Verify at the official NPI Registry.