COLQUITT REGIONAL MEDICAL CENTER (NPI# 1316154834) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316154834 |
| Entity Type | Organization |
| Organization Name | COLQUITT REGIONAL MEDICAL CENTER |
| Other Organization Name | COLQUITT REGIONAL HOSPICE |
| Practice Address |
2516 5th Ave Se Moultrie GA 31788-6207 |
| Mailing Address |
2516 5th Ave Se Po Box 3548 Moultrie GA 31788-6207 |
| Practice Telephone | 2299853420 |
| Mailing Telephone | 2299853420 |
| Enumeration Date | 2007-05-16 |
| Last Update Date | 2012-04-25 |
| Authorized Official Name | MR. JAMES L MATNEY (PRESIDENT) |
| Authorized Official Telephone | 2299853420 |
| Is Organization Subpart | Y |
| Parent Organization Name | COLQUITT REGIONAL MEDICAL CENTER |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251G00000X | Hospice Care, Community Based | 035069 | GA | Agencies |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 000694152A | 05 |
| Other Name | Type Code |
|---|---|
| Colquitt Regional Hospice | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912099094 | Colquitt Regional Medical Center | Ambulance | 3131 South Main St, Moultrie, GA 31768-6925 | 2006-09-28 |
| 1720593239 | Colquitt Regional Medical Center | Ambulance | 3131 S Main St, Moultrie, GA 31768-6925 | 2017-12-06 |
| 1962850396 | Colquitt Regional Medical Center | Family Medicine | 1 Magnolia Ct, Moultrie, GA 31768 | 2016-05-26 |
| 1720359326 | Colquitt Regional Medical Center | Medicare Defined Swing Bed Unit | 3131 S Main St, Moultrie, GA 31768-6925 | 2012-01-13 |
| 1124155965 | Colquitt Regional Medical Center | Clinic/Center | 3131 S Main St, Moultrie, GA 31768-6925 | 2007-02-28 |
| 1881758753 | Colquitt Regional Medical Center | Clinic/Center | 6 Hospital Park, Moultrie, GA 31768-6700 | 2006-12-21 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | COLQUITT REGIONAL MEDICAL CENTER | 3131 S Main St, Moultrie, GA 31768-6925 |
| Street Address |
2516 5TH AVE SE |
| City | MOULTRIE |
| State | GA |
| Zip Code | 31788-6207 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558375840 | Colquitt Regional Health Incorporated | Home Health | 2516 5th Ave Se, Moultrie, GA 31788-6207 | 2006-07-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295283620 | Convenient Rx LLC | Pharmacy | 640 Veterans Pkwy N, Moultrie, GA 31788 | 2016-09-14 |
| 1861745994 | Sherry Marie Mccoy | Clinical Nurse Specialist | 3015 Veterans Parkaway, Moultrie, GA 31788 | 2012-10-26 |
| 1083874895 | Opal Jean M Norman | Speech-Language Pathologist | 4969 Old Adel Rd, Moultrie, GA 31788-1276 | 2008-06-16 |
| 1558440800 | Colquitt County Board of Education | Local Education Agency (LEA) | 348 Industrial Dr, Moultrie, GA 31788-1842 | 2006-11-06 |
| 1295378982 | Jamshaid Mukhtar Cheema | Physician Assistant | Turning Point Care Center, 3015 Veterans Pkway S, Moultrie, GA 31788-2397 | 2019-10-24 |
| 1508313164 | Publix Super Markets Inc | Durable Medical Equipment & Medical Supplies | 378 Veterans Pkwy N, Moultrie, GA 31788-4171 | 2016-09-01 |
| 1518347418 | Careconnect Health, Inc. | Clinic/Center | 358 Veterans Pkwy N, Moultrie, GA 31788-4171 | 2015-06-05 |
| 1528674439 | Lindsay Mobley | Pharmacist | 378 Veterans Pkwy N, Moultrie, GA 31788-4171 | 2020-09-17 |
| 1346727955 | Courtney Foy Edwards | Pharmacist | 378 Veterans Pkwy N, Moultrie, GA 31788-4171 | 2018-07-26 |
| 1538689757 | Lauren Milligan | Social Worker | 358 Veterans Pkwy N, Moultrie, GA 31788-4171 | 2017-06-20 |
| Find all providers in zip 31788 | ||||
| Taxonomy Code | 251G00000X |
| Grouping | Agencies |
| Classification | Hospice Care, Community Based |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952348435 | Southerncare, Inc. | Hospice Care, Community Based | 143 South Highway 319, Suite 1, Moultrie, GA 31768-4733 | 2006-06-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477153492 | Legacy Hospice Ga | Hospice Care, Community Based | 1700 Frederica Rd Ste 205, St Simons Island, GA 31522-2583 | 2020-10-28 |
| 1013515030 | Perimeter Hospice of Georgia | Hospice Care, Community Based | 150 Stanley Ct Ste E, Lawrenceville, GA 30046-5215 | 2020-10-12 |
| 1780291039 | Goldencare Hospice and Palliative Care | Hospice Care, Community Based | 7555 Bridgegate Ct, Sandy Springs, GA 30350-4604 | 2020-09-29 |
| 1255947651 | Community Hospice of Georgia | Hospice Care, Community Based | 321 N Main St Ste A, Adairsville, GA 30103-2403 | 2020-09-21 |
| 1437762382 | Allaway Angels | Hospice Care, Community Based | 805 Deerfield Ct, Stone Mountain, GA 30087-5483 | 2020-08-28 |
| 1144832494 | Circle of Hope Hospice | Hospice Care, Community Based | 5750 Brook Hollow Pkwy Ste 105, Norcross, GA 30071-3515 | 2020-08-18 |
| 1518578335 | Jaslinks Hospice Inc | Hospice Care, Community Based | 2282 Meadow Church Rd Ste 300, Duluth, GA 30097-5318 | 2020-08-14 |
| 1104434570 | An Angels Touch Hospice LLC | Hospice Care, Community Based | 2345 4th St Ste 600d, Tucker, GA 30084-8518 | 2020-07-21 |
| 1609494327 | Divine Guardian LLC | Hospice Care, Community Based | 2321 4th St Ste 210, Tucker, GA 30084-8516 | 2020-07-09 |
| 1184242026 | Champions Nursing Services, LLC | Hospice Care, Community Based | 2365 Wall St Se Ste 210, Conyers, GA 30013-2197 | 2020-07-07 |
| 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.