Medlink Georgia, Inc

Primary specialty

Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X

Legal business name

MEDLINK GEORGIA, INC

Practice address

811 Highway 441 N, Ste 103
Clayton, GA 30525-4202

Phone

(706) 942-4030

NPI assigned

Apr 8, 2022

Last updated

Apr 15, 2026By the provider in NPPES

Organization subpart

Yes

Parent organization

MEDLINK GEORGIA, INCAs reported in NPPES

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

Authorized official

Name

Dave Ward

Title

Ceo

Phone

(706) 788-3234

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA2 enrollments

Enrollment records 2

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1992447247. Details of each certification follow.

• CCN C21063 Federally qualified health center · Active · Details

Federally qualified health center certification: CCN C21063

Legal name

MEDLINK GEORGIA INC

Doing business as

MEDLINK RABUN SPECIALTY SERVICES

Certification status

Active

Provider type (POS)

Federally qualified health center

Participating since

Mar 19, 2026

Last certification

Mar 19, 2026

Ownership / control type

For profit – corporation

Organization structure

CorporationNon-profit

Enrollment address

811 Highway 441 N
Ste 103
Clayton, GA 30525-4202

Tax ID family

NE Ga Family Med Ctr in47 organizations share this tax ID, including this one

Part of

NE Ga Family Med Ctr in

Other organizations with this tax ID 46

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

• Medlink Georgia Inc

  dba MedLink White School Based Health Center

  • Federally Qualified Health Center (FQHC)
  • Cleveland, GA
  • NPI 1023746054
  NPD tax ID
• Medlink Georgia Inc

  • Federally Qualified Health Center (FQHC)
  • Winder, GA
  • NPI 1033229059
  NPD tax ID
• Medlink Georgia Inc

  • Federally Qualified Health Center (FQHC)
  • Commerce, GA
  • NPI 1033304274
  NPD tax ID
• Medlink Georgia Inc

  • Federally Qualified Health Center (FQHC)
  • Lexington, GA
  • NPI 1083724082
  NPD tax ID
• Medlink Georgia Inc

  dba MedLink Oconee

  • Federally Qualified Health Center (FQHC)
  • Watkinsville, GA
  • NPI 1093401895
  NPD tax ID
• Medlink Georgia Inc

  dba MedLink Pharmacy - Habersham

  • Community/Retail Pharmacy
  • Demorest, GA
  • NPI 1174177638
  NPD tax ID
• Medlink Georgia Inc

  • Federally Qualified Health Center (FQHC)
  • Bowman, GA
  • NPI 1235249236
  NPD tax ID
• Medlink Georgia Inc

  • Federally Qualified Health Center (FQHC)
  • Gainesville, GA
  • NPI 1245340264
  NPD tax ID
• Medlink Georgia Inc

  dba Medlink Pharmacy- Colbert

  • Community/Retail Pharmacy
  • Colbert, GA
  • NPI 1245732254
  NPD tax ID
• Medlink Georgia Inc

  • Federally Qualified Health Center (FQHC)
  • Hartwell, GA
  • NPI 1275643272
  NPD tax ID
• Medlink Georgia Inc

  • Federally Qualified Health Center (FQHC)
  • Royston, GA
  • NPI 1336259340
  NPD tax ID
• Medlink Georgia Inc

  • Federally Qualified Health Center (FQHC)
  • Clayton, GA
  • NPI 1346299807
  NPD tax ID

All disclosed owners & managing parties 21

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

Owners & managing parties with NPI records 2

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

• Mushtaq Ahmed, M.D.

  • Family Medicine Physician
  • Winder, GA
  • NPI 1457592552

  W-2 Managing Employee

  CMS ownership
• Alexandra Hoffman Duvall, PA-C

  • Physician Assistant
  • Hiawassee, GA
  • NPI 1629318191

  Corporate Director

  CMS ownership

All facility ownership & control disclosures 11

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Practitioners 1

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.

• Sheila Sheftall Cannon, MD

  • Psychiatry Physician
  • Peachtree City, GA
  • NPI 1043385602
  NPD (past)

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

{
    "created_epoch": "1649376000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1776211200000",
    "number": "1992447247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 459",
            "city": "COLBERT",
            "state": "GA",
            "postal_code": "306280459",
            "telephone_number": "706-788-3234",
            "fax_number": "706-788-2936"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "811 HIGHWAY 441 N, STE 103",
            "city": "CLAYTON",
            "state": "GA",
            "postal_code": "305254202",
            "telephone_number": "706-942-4030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDLINK GEORGIA, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MEDLINK GEORGIA, INC",
        "enumeration_date": "2022-04-08",
        "last_updated": "2026-04-15",
        "certification_date": "2026-04-15",
        "status": "A",
        "authorized_official_last_name": "WARD",
        "authorized_official_first_name": "DAVE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "706-788-3234"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Medlink Georgia Inc (MedLink Rabun Behavioral Health)
• Medlink Georgia, Inc (MedLink Rabun North)
• Medlink Georgia, Inc (MedLink Rabun Women's Center)
• Medlink Georgia, Inc (MedLink Rabun Imaging)
• Medlink Georgia, Inc (MedLink Pharmacy - Rabun)
• Ashley D. Miller, OTR/L
• Autumn Mills, NP-C
• Mlmcuc, LLC (Mountain Lakes Medical Group)
• Mlmcuc, LLC (Mountain Lakes Medical Group)
• Lisa Mooney

• Federally Qualified Health Center (FQHC) in Clayton, GA
• Providers in Clayton, GA by specialty
• Federally Qualified Health Center (FQHC) in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.