GEORGIA MOUNTAINS HEALTH SERVICES, INC. (NPI# 1225399041) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1225399041 |
| Entity Type | Organization |
| Organization Name | GEORGIA MOUNTAINS HEALTH SERVICES, INC. |
| Practice Address |
218 N Fredrick St Dalton GA 30721-3242 |
| Mailing Address |
165 Blue Ridge Overlook Blue Ridge GA 30513-4431 |
| Practice Telephone | 7065293643 |
| Practice Fax Number | 7063747628 |
| Mailing Telephone | 7069465600 |
| Mailing Fax Number | 7063747628 |
| Enumeration Date | 2012-06-07 |
| Last Update Date | 2017-12-19 |
| Authorized Official Name | STEVEN MIRACLE (CEO) |
| Authorized Official Telephone | 7069465610 |
| Is Organization Subpart | Y |
| Parent Organization Name | GEORGIA MOUNTAINS HEALTH SERVICES, INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 003126037A | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124684618 | Georgia Mountains Health Services, Inc. | Clinic/Center | 4560 Old Highway 76, Blue Ridge, GA 30513-4756 | 2019-05-10 |
| 1396940029 | Georgia Mountains Health Services, Inc. | Clinic/Center | 772 Maddox Drive, Suite 122, East Ellijay, GA 30540-8196 | 2007-06-21 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | GEORGIA MOUNTAINS HEALTH SERVICES, INC. | 165 Blue Ridge Overlook, Blue Ridge, GA 30513-4431 |
| Street Address |
218 N FREDRICK ST |
| City | DALTON |
| State | GA |
| Zip Code | 30721-3242 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104848498 | Deloris Ann Hefner | Registered Nurse | 218 N Fredrick St, Dalton, GA 30721-3242 | 2006-07-24 |
| 1649310236 | Wiley Allen Smith | Family Medicine | 218 N Fredrick St, Dalton, GA 30721-3242 | 2007-02-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417322942 | Alison Gobel | Case Manager/Care Coordinator | 2611 Clevland Hwy, Dalton, GA 30721 | 2015-12-09 |
| 1528433026 | Crystal Sparks | Case Manager/Care Coordinator | 2611 Cleveland Highway, Dalton, GA 30721 | 2015-12-09 |
| 1043524838 | Quality Care Concepts, Inc. | Durable Medical Equipment & Medical Supplies | 121 Tilton Road, Dalton, GA 30721 | 2010-08-04 |
| 1538490081 | Jennifer Sawyer | Counselor | 720 S. Glenwood Ave, Ste 112, Dalton, GA 30721 | 2010-01-22 |
| 1831210673 | Linda E. Minter | Case Manager/Care Coordinator | 932 Williams Rd. Nw, Dalton, GA 30721 | 2007-04-02 |
| 1265595318 | M Edwin Caylor Dds PC | Dentist | 2880 Cleveland Hwy, Dalton, GA 30721 | 2006-12-19 |
| 1295823003 | Candler Road Dental, PC | Dentist | 2107 E. Walnut Ave., Dalton, GA 30721 | 2006-10-10 |
| 1508872466 | Family Walk-in Clinic | Family Medicine | 1100 E Walnut Avenue, Suite 14 & 15, Dalton, GA 30721 | 2006-07-31 |
| 1225056823 | James L Coone | Family Medicine | 1100 E. Walnut Avenue, Suite 14 & 15, Dalton, GA 30721 | 2006-07-18 |
| 1770517591 | The Kroger Co | Durable Medical Equipment & Medical Supplies | 1205 N Glenwood Road, Dalton, GA 30721 | 2006-07-10 |
| Find all providers in zip 30721 | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821332495 | Georgia Mountains Health Services, Inc | Clinic/Center | 900 Shugart Rd, Dalton, GA 30720-2467 | 2012-11-20 |
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| 1023658523 | Saint Joseph's Mercy Care Services, Inc. | Clinic/Center | 1407 Cobb Parkway Nw, Marietta, GA 30060-6546 | 2020-01-13 |
| 1467092221 | Careconnect Health, Inc. | Clinic/Center | 130 N Lee St, Forsyth, GA 31029-2122 | 2020-01-09 |
| 1417597238 | The Family Health Centers of Georgia, Inc | Clinic/Center | 19 John Maddox Dr Nw Ste B, Rome, GA 30165-1477 | 2020-01-09 |
| 1649810714 | Careconnect Health, Inc. | Clinic/Center | 254 Wright Avenue, Roberta, GA 31078 | 2020-01-07 |
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| 1285277608 | Saint Joseph's Mercy Care Services, Inc. | Clinic/Center | 1976 Flat Shoals Rd Se Ste B, Atlanta, GA 30316-2857 | 2019-10-18 |
| Find all providers with the same taxonomy | ||||
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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.