Terrell County Board of Health

Primary specialty

Public Health or Welfare AgencyTaxonomy code 251K00000X

Legal business name

TERRELL COUNTY BOARD OF HEALTH

Practice address

969 Forrester Dr SE
Dawson, GA 39842-2106

Phone

(229) 995-2188

Fax

(229) 995-2074

NPI assigned

Oct 31, 2005

Organization subpart

No

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

Authorized official

Name

Charles D Ruis, MD

Title

District Health Director

Phone

(229) 352-4275

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Locations

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

{
    "created_epoch": "1130716800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1508716800000",
    "number": "1992796965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "969 FORRESTER DR SE",
            "city": "DAWSON",
            "state": "GA",
            "postal_code": "398422106",
            "telephone_number": "229-995-2188",
            "fax_number": "229-995-2074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "969 FORRESTER DR SE",
            "city": "DAWSON",
            "state": "GA",
            "postal_code": "398422106",
            "telephone_number": "229-995-2188",
            "fax_number": "229-995-2074"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TERRELL COUNTY BOARD OF HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-31",
        "last_updated": "2017-10-23",
        "status": "A",
        "authorized_official_last_name": "RUIS",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "DISTRICT HEALTH DIRECTOR",
        "authorized_official_telephone_number": "229-352-4275",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": "GA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00456475L",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00560898B",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00452933L",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00052049M",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michelle Shirah
• Softline Home Support
• Hannah Speaks
• Terrell Co EMS
• Terrell County Board of Education
• Terrell County Commissioner of Roads & Revenues
• Terrell Lee (Now)
• Terrell Lee Day (Comp)
• Terrell Lee Supportive Employment (Comp)
• Terrell Lee Supportive Employment (Now)

• All providers in Dawson, GA
• Public Health or Welfare Agency in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2017; 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.