Active NPI
MCG Health, Inc
- Psychiatric Hospital Unit
- Augusta, GA
National Provider Identifier
1992986293
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric Hospital Unit
- License
- 011-104
- Legal business name
- MCG HEALTH, INC
- Practice address
- 1120 15TH St
Augusta, GA 30912-0004 - Phone
- (706) 721-0211
- NPI assigned
- Nov 15, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Donald Snell
- Title
- President and Ceo
- Phone
- (706) 721-0211
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric Hospital Unit | 273R00000X | 011-104 | GA | Primary |
Addresses
Primary practice location
1120 15TH St
Augusta, GA 30912-0004
Mailing address
1120 15TH St
Augusta, GA 30912-0004
Phone (706) 721-0211
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 358127 | Medicaid | SC | |
| 000418 | Other | BLUE CROSS | |
| 00000723A | Medicaid | GA | |
| 315846 | Medicaid | SC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040312000081 | GA | Part B Supplier - Clinic/Group Practice | 7618866229 |
Receives reassigned benefits from 95 practitioners 1 other NPI on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Augusta, GA |
Other NPIs on the same Medicare enrollment 1
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1195084800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1208649600000",
"number": "1992986293",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1120 15TH ST",
"city": "AUGUSTA",
"state": "GA",
"postal_code": "309120004",
"telephone_number": "706-721-0211"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1120 15TH ST",
"city": "AUGUSTA",
"state": "GA",
"postal_code": "309120004",
"telephone_number": "706-721-0211"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MCG HEALTH, INC",
"organizational_subpart": "NO",
"enumeration_date": "2007-11-15",
"last_updated": "2008-04-20",
"status": "A",
"authorized_official_last_name": "SNELL",
"authorized_official_first_name": "DONALD",
"authorized_official_title_or_position": "PRESIDENT AND CEO",
"authorized_official_telephone_number": "706-721-0211",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "273R00000X",
"taxonomy_group": "",
"desc": "Psychiatric Unit",
"state": "GA",
"license": "011-104",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "358127",
"state": "SC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS",
"identifier": "000418",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00000723A",
"state": "GA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "315846",
"state": "SC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Augusta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2008; 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.