THE HOSPITAL AUTHORITY OF HABERSHAM COUNTY (NPI# 1184757965) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184757965 |
| Entity Type | Organization |
| Organization Name | THE HOSPITAL AUTHORITY OF HABERSHAM COUNTY |
| Other Organization Name | HERITAGE INTERNAL MEDICINE |
| Practice Address |
801 Austin Dr Demorest GA 30535-4513 |
| Mailing Address |
396 Historic Highway 441 N Demorest GA 30535 |
| Practice Telephone | 7067543287 |
| Practice Fax Number | 7067547300 |
| Mailing Telephone | 7067543287 |
| Mailing Fax Number | 7067547300 |
| Enumeration Date | 2007-03-13 |
| Last Update Date | 2014-03-26 |
| Authorized Official Name | MR. JERRY R WISE (CEO) |
| Authorized Official Telephone | 7067542161 |
| Is Organization Subpart | Y |
| Parent Organization Name | THE HOSPITAL AUTHORITY OF HABERSHAM COUNTY |
| Parent Organization TIN |
|
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | 4705360 | GA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | CLIA # | 11D0944659 | 01 |
| GA | TRAVELERS RAILROAD MCR | DA0733 | 01 |
| Other Name | Type Code |
|---|---|
| Heritage Internal Medicine | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114417128 | The Hospital Authority of Habersham County | Family Medicine | 638 Hwy 441 N Suite B-2, Demorest, GA 30535 | 2018-05-15 |
| 1285847343 | The Hospital Authority of Habersham County | Family Medicine | 801 Austin Drive, Demorest, GA 30535 | 2007-05-07 |
| 1508985714 | The Hospital Authority of Habersham County | Ambulance | 111 Habersham Terrace Gdns, Demorest, GA 30535-4558 | 2007-03-28 |
| 1285767053 | The Hospital Authority of Habersham County | Family Medicine | 17 White Street, Cleveland, GA 30528 | 2007-03-13 |
| 1649302811 | The Hospital Authority of Habersham County | Skilled Nursing Facility | 541 Highway 441 N, Demorest, GA 30535 | 2007-03-12 |
| 1578624185 | The Hospital Authority of Habersham County | Home Health | 1040 Highway 441 N, Demorest, GA 30535-4123 | 2006-12-13 |
| 1740778828 | The Hospital Authority of Habersham County | Clinic/Center | 638 Historic Hwy 441 N, Suite B-1, Demorest, GA 30535 | 2018-04-25 |
| 1639604986 | The Hospital Authority of Habersham County | Family Medicine | 541 Historic Hwy 441 N, Demorest, GA 30535 | 2017-04-25 |
| 1679005144 | The Hospital Authority of Habersham County | Family Medicine | 801 Austin Dr, Demorest, GA 30535-4513 | 2017-04-03 |
| 1801333455 | The Hospital Authority of Habersham County | Nurse Anesthetist, Certified Registered | 541 441 Historic Hwy N, Demorest, GA 30535-4528 | 2017-01-20 |
| Street Address |
801 AUSTIN DR |
| City | DEMOREST |
| State | GA |
| Zip Code | 30535-4513 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104916584 | David Allen Bray | Internal Medicine | 801 Austin Dr, Demorest, GA 30535-4513 | 2006-10-13 |
| 1679005144 | The Hospital Authority of Habersham County | Family Medicine | 801 Austin Dr, Demorest, GA 30535-4513 | 2017-04-03 |
| 1104024025 | Tammy Danielle Farmer | Nurse Practitioner | 801 Austin Dr, Demorest, GA 30535-4513 | 2007-07-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396353355 | Kristen Diana Maxwell X | Nurse Practitioner | 396 Historic Highway 441 North, Demorest, GA 30535 | 2020-07-16 |
| 1659925972 | Jared Davis | Physical Therapist | 541 Historic Hiwy 441, Demorest, GA 30535 | 2019-07-25 |
| 1669939070 | Habersham Medical Center Foundation, Inc. | Pharmacy | 541 Old Historic Hwy 441 N Ste 1, Demorest, GA 30535 | 2019-02-22 |
| 1114417128 | The Hospital Authority of Habersham County | Family Medicine | 638 Hwy 441 N Suite B-2, Demorest, GA 30535 | 2018-05-15 |
| 1578077434 | Linh My Dao | Registered Nurse | 541 Historic Hwy. 441-n, Demorest, GA 30535 | 2017-11-29 |
| 1447797063 | Cmvo, LLC | Pharmacy | 4654 Highway 115, Unit 1, Demorest, GA 30535 | 2017-01-20 |
| 1851741128 | Katherine Glenn | Physical Therapy Assistant | 541 Us-441 Bus, Demorest, GA 30535 | 2016-06-17 |
| 1558735886 | Waterfall Emergency Physicians, LLC | Physician Assistant | 541 Historic Hwy 441n, Demorest, GA 30535 | 2015-11-24 |
| 1407278237 | Deborah Gale | Pharmacist | 116 Savannah Ter, Demorest, GA 30535 | 2014-01-14 |
| 1538580576 | Garrett Family Medicine, LLC | Family Medicine | 590 Historic Hwy 441 Lower Level, Demorest, GA 30535 | 2013-12-18 |
| Find all providers in zip 30535 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053615641 | Nancy M Watson Md PC | Internal Medicine | 676 441 Historic Hwy N, Demorest, GA 30535-4523 | 2010-12-22 |
| 1174688121 | James Lewis Brown Jr. | Internal Medicine | 638 Historic Hwy 441 N, Suite B, Demorest, GA 30535-3053 | 2006-12-27 |
| 1104916584 | David Allen Bray | Internal Medicine | 801 Austin Dr, Demorest, GA 30535-4513 | 2006-10-13 |
| 1750305058 | Nancy M Watson | Internal Medicine | 676 Historic Hwy 441 North, Demorest, GA 30535 | 2006-07-27 |
| 1760410146 | Kecia Jackson Jones | Internal Medicine | 225 Adams Drive, Suite 2, Demorest, GA 30535 | 2006-06-28 |
| 1679557805 | William Rhett Weaver | Internal Medicine | 835 Austin Dr, Demorest, GA 30535-4513 | 2005-12-01 |
| 1215911672 | Heritage Internal Medicine, Inc. | Internal Medicine | 396 Hwy 441 N, Suite A, Demorest, GA 30535-0579 | 2005-11-30 |
| 1912995226 | Brenda J Garland | Internal Medicine | 396 Highway 441, Demorest, GA 30535-0579 | 2005-10-11 |
| 1093717357 | Family Practice of Habersham PC | Internal Medicine | 590 Historic Hwy 441 N, Demorest, GA 30535 | 2005-06-01 |
| 1912140278 | Laura Heringer | Internal Medicine | 638 Historic Hwy 441 N, Suite B, Demorest, GA 30535 | 2009-04-15 |
| Find all providers in DEMOREST | ||||
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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.