MEDICAL COLLEGE OF GEORGIA (NPI# 1114138849) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114138849 |
| Entity Type | Organization |
| Organization Name | MEDICAL COLLEGE OF GEORGIA |
| Practice Address |
Prison Rd Sparta GA 31081 |
| Mailing Address |
Po Box 224 Milledgeville GA 31059-0224 |
| Practice Telephone | 7064441052 |
| Mailing Telephone | 7064441050 |
| Enumeration Date | 2007-05-24 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MR. DAVID BUTTS (HEALTH SERVICE ADMINISTRATOR) |
| Authorized Official Telephone | 7064441052 |
| Authorized Official Credential | HSA |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2400X |
Clinic/Center Specialization: Prison Health |
050206 | GA | Ambulatory Health Care Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609078047 | Medical College of Georgia | General Acute Care Hospital | 1120 15th St # Baa-5407, Augusta, GA 30912-0004 | 2007-06-05 |
| 1285842856 | Medical College of Georgia | General Acute Care Hospital | 1423 Harper St, Augusta, GA 30912-0021 | 2007-05-18 |
| 1255454070 | Medical College of Georgia | Chronic Disease Hospital | 623 Walden Hills Cir, 623, Augusta, GA 30909-0223 | 2007-04-08 |
| 1568543551 | Medical College of Georgia | Specialist | 1120 15th St, Bp-2109, Augusta, GA 30912-0004 | 2006-10-18 |
| Street Address |
PRISON RD |
| City | SPARTA |
| State | GA |
| Zip Code | 31081 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790386951 | Katherine Grace Dymacz | Nurse Practitioner | 376 Lafayette Rd Ste 101, Sparta, NJ 07871-3560 | 2020-11-04 |
| 1538769047 | Results-ast Jv, LLC | Physical Therapist | 421 Sewell Road, Sparta, TN 38583 | 2020-10-26 |
| 1376141143 | Phillips Pharmacy, LLC | Pharmacy | 7278 State Highway 14 E, Sparta, MO 65753-9345 | 2020-10-14 |
| 1326655564 | Ryan Joseph Jones | Social Worker | 904 Angelo Rd, Sparta, WI 54656-1416 | 2020-09-30 |
| 1235746033 | Roberta A Thomas | Licensed Practical Nurse | 399 S Union St Apt 15, Sparta, MI 49345-1534 | 2020-09-25 |
| 1801402086 | Samantha Taylor | Behavior Technician | 425 Martindale St, Sparta, MI 49345-1467 | 2020-09-22 |
| 1750997144 | Kellie Elizabeth Hackett | Social Worker | 43 Main St Ste 101, Sparta, NJ 07871-1972 | 2020-09-21 |
| 1902412737 | Jennifer Lynne Coviello | Physical Therapist | 10 North N Village Blvd, Suite D, Sparta, NJ 07871 | 2020-09-17 |
| 1356956189 | Taylor Harbaugh | Speech-Language Pathologist | 203 Dean Ave, Sparta, IL 62286-2301 | 2020-09-09 |
| 1215541214 | Lashonda R. Chapple | Home Health | 50 Burnt Dr, Sparta, GA 31087-1202 | 2020-09-07 |
| Find all providers in SPARTA | ||||
| Taxonomy Code | 261QP2400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Prison Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023227394 | Leonor Nmn Bonnet-engebretson | Clinic/Center | 3212 Walnut Rdg, Atlanta, GA 30349-8745 | 2007-05-22 |
Please comment or provide details below to improve the information on MEDICAL COLLEGE OF GEORGIA.
| 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.