TATTNALL HOSPITAL COMPANY LLC (NPI# 1023253408) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023253408 |
| Entity Type | Organization |
| Organization Name | TATTNALL HOSPITAL COMPANY LLC |
| Other Organization Name | OPTIM PRIMARY CARE - COBBTOWN |
| Practice Address |
36671 Hwy 23 Cobbtown GA 30420-6042 |
| Mailing Address |
210 E Derenne Ave Savannah GA 31405-6736 |
| Practice Telephone | 9125571000 |
| Mailing Telephone | 9126445300 |
| Mailing Fax Number | 9126445260 |
| Enumeration Date | 2008-12-12 |
| Last Update Date | 2015-07-27 |
| Authorized Official Name | MR. ROBERT GUENTHNER (SECRETARY OF COMM.HOSP.HOLD.CO., LL) |
| Authorized Official Telephone | 3126278427 |
| Is Organization Subpart | Y |
| Parent Organization Name | TATTNALL HOSPITAL COMPANY. LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207R00000X | Internal Medicine | 038774 | GA | Allopathic & Osteopathic Physicians |
| Y | 261QR1300X |
Clinic/Center Specialization: Rural Health |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MEDICARE PART A | 118512 | 01 | |
| GA | 925639844B | 05 |
| Other Name | Type Code |
|---|---|
| Optim Primary Care - Cobbtown | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831682327 | Tattnall Hospital Company LLC | Occupational Therapist | 8201 Pinellas Dr, Bluffton, SC 29910 | 2018-06-11 |
| 1134573660 | Tattnall Hospital Company LLC | Physical Therapist | 810 Towne Park Dr, Suite 200, Rincon, GA 31326-5171 | 2016-04-21 |
| 1992072722 | Tattnall Hospital Company LLC | Psychiatry & Neurology | 16 Okatie Center Blvd S, Suite 201, Okatie, SC 29909-7533 | 2011-11-22 |
| 1821607359 | Tattnall Hospital Company LLC | Orthopaedic Surgery | 610 Sparta Rd, Sandersville, GA 31082-1860 | 2020-07-30 |
| 1578197331 | Tattnall Hospital Company LLC | Neurological Surgery | 42 Truman Rd, Hawkinsville, GA 31036-4644 | 2020-03-02 |
| 1114551975 | Tattnall Hospital Company LLC | Neurological Surgery | 425 N Cobb St, Milledgeville, GA 31061-2634 | 2020-03-02 |
| 1902430457 | Tattnall Hospital Company LLC | Orthopaedic Surgery | 305 Pineview Dr, Waycross, GA 31501-5229 | 2020-02-24 |
| 1750890562 | Tattnall Hospital Company LLC | Neurological Surgery | 121 N Crest Blvd, Macon, GA 31210-1845 | 2017-09-25 |
| 1255877361 | Tattnall Hospital Company LLC | Orthopaedic Surgery | 11 Cross St, Hazlehurst, GA 31539-6427 | 2017-01-12 |
| 1477909364 | Tattnall Hospital Company LLC | Physical Therapist | 3301 E 1st St, Suite B, Vidalia, GA 30474-8674 | 2016-05-10 |
| Street Address |
36671 HWY 23 |
| City | COBBTOWN |
| State | GA |
| Zip Code | 30420-6042 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952416901 | Tattnall Healthcare LLC | Clinic/Center | 36671 Hwy. 23, Cobbtown, GA 30420 | 2006-08-20 |
| 1811972482 | Innovative Health Systems, Inc. | Pharmacy | 298 Railroad St, Cobbtown, GA 30420-6012 | 2005-12-07 |
| 1467561456 | Sandra Flynt Cardell | Pharmacist | 298 Railroad St, Cobbtown, GA 30420-6012 | 2006-08-30 |
| 1790703833 | Ronda D Williamson | Nurse Practitioner | 36671 Highway 23, Cobbtown, GA 30420-6042 | 2006-07-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952416901 | Tattnall Healthcare LLC | Clinic/Center | 36671 Hwy. 23, Cobbtown, GA 30420 | 2006-08-20 |
| 1811972482 | Innovative Health Systems, Inc. | Pharmacy | 298 Railroad St, Cobbtown, GA 30420-6012 | 2005-12-07 |
| 1467561456 | Sandra Flynt Cardell | Pharmacist | 298 Railroad St, Cobbtown, GA 30420-6012 | 2006-08-30 |
| Taxonomy Code | 261QR1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rural Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952416901 | Tattnall Healthcare LLC | Clinic/Center | 36671 Hwy. 23, Cobbtown, GA 30420 | 2006-08-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437651924 | Amanda Mckenzie | Clinic/Center | Us Renal Care 657 Hemlock Street, Macon, GA 31206 | 2018-03-01 |
| 1518398049 | Norman Park Family Medicine Clinic | Clinic/Center | 139 East Broad Street, Norman Park, GA 31771 | 2013-12-10 |
| 1992147573 | Doerun Family Medicine Clinic | Clinic/Center | 128 West Broad Ave, Doerun, GA 31744 | 2013-07-23 |
| 1366784415 | Emanuel County Hospital Authority | Clinic/Center | 131a Victory Dr, Swainsboro, GA 30401-3234 | 2013-03-26 |
| 1306114004 | Lower Oconee Community Hospital, Inc | Clinic/Center | 421 W Robinson Dr, Mount Vernon, GA 30445-2935 | 2011-12-08 |
| 1013248962 | Southern Health Corp of Ellijay | Clinic/Center | 60 Old Highway 5 South, Ellijay, GA 30540-5436 | 2010-01-15 |
| 1427384353 | Union County Hospital Authority | Clinic/Center | 103 Church St Ste A, Hiawassee, GA 30546-3223 | 2009-10-28 |
| 1346574084 | Durall Capital Holdings, LLC | Clinic/Center | 59 Tipton Drive, Dahlonega, GA 30533 | 2009-09-29 |
| 1215260617 | Durall Capital Holdings, LLC | Clinic/Center | 35 Lumpkin Campground Road N, Dawsonville, GA 30534 | 2009-09-16 |
| 1376778001 | Phoebe Sumter Medical Center, Inc | Clinic/Center | 339 S Broad St, Ellaville, GA 31806-3304 | 2009-05-26 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.