PRIMARY CARE OF SOUTHWEST GEORGIA, INC (NPI# 1407375686) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407375686 |
| Entity Type | Organization |
| Organization Name | PRIMARY CARE OF SOUTHWEST GEORGIA, INC |
| Other Organization Name | PRIMARY CARE OF SOUTHWEST GEORGIA-TCMS |
| Practice Address |
4681 Us Highway 84 Byp W Thomasville GA 31792-2607 |
| Mailing Address |
360 College St Blakely GA 39823-2554 |
| Practice Telephone | 2292272936 |
| Practice Fax Number | 2292255284 |
| Mailing Telephone | 2297232660 |
| Enumeration Date | 2017-09-19 |
| Last Update Date | 2017-09-19 |
| Authorized Official Name | EDWIN JAMES (CFO) |
| Authorized Official Telephone | 2297232660 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Primary Care of Southwest Georgia-TCMS | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992102073 | Primary Care of Southwest Georgia, Inc | Clinic/Center | 916 S Broad St, Unit B-2, Thomasville, GA 31792-6113 | 2014-12-04 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | PRIMARY CARE OF SOUTHWEST GEORGIA, INC. | 360 College St, Blakely, GA 39823-2554 |
| Street Address |
4681 US HIGHWAY 84 BYP W |
| City | THOMASVILLE |
| State | GA |
| Zip Code | 31792-2607 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780922849 | Rachael Clark Lackey | Nurse Practitioner | 4681 Us Highway 84 Byp W, Thomasville, GA 31792-2607 | 2013-01-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245739879 | Georgia Pines Community Service Board | Community/Behavioral Health | 407 Cloverdale Drive, Thomasville, GA 31792 | 2018-02-09 |
| 1932613551 | Diana Diaz | Physician Assistant | 2705 E Pinetree Blvd Ste A, Thomasville, GA 31792 | 2017-11-17 |
| 1194249425 | Bobbie Frazier | Contractor | 400 Cloverdale Dr, Thomasville, GA 31792 | 2017-07-28 |
| 1598132292 | Southern Scripts, LLC | Pharmacy | 501 Gordon Avenue, Thomasville, GA 31792 | 2015-08-28 |
| 1508248915 | Elizabeth Nicole Keen | Behavioral Analyst | 121 Covington Ave Apt 9, Thomasville, GA 31792 | 2015-06-22 |
| 1417341579 | Sheila L Stanley | Counselor | 301 Summercreek Cove, Thomasville, GA 31792 | 2015-03-26 |
| 1457749301 | Ashley Lamb | Speech-Language Pathologist | 1203 East Jackson Street, Thomasville, GA 31792 | 2014-12-30 |
| 1831403880 | Somnoquest | Durable Medical Equipment & Medical Supplies | 556 Hall Road, Thomasville, GA 31792 | 2010-08-02 |
| 1508000183 | Kashyap B Choksi | Internal Medicine | 100 Mimosa Drive 2nd Floor, Thomasville, GA 31792 | 2009-04-27 |
| 1205008786 | Mark J Glaccum | Chiropractor | 415 Gordon Avenue, Thomasville, GA 31792 | 2008-03-25 |
| Find all providers in zip 31792 | ||||
| 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 |
|---|---|---|---|---|
| 1235489683 | Albany Area Primary Health Care, Inc | Clinic/Center | 14540 Us Hwy 19 S Ste#1, Thomasville, GA 31757 | 2012-09-13 |
| 1992102073 | Primary Care of Southwest Georgia, Inc | Clinic/Center | 916 S Broad St, Unit B-2, Thomasville, GA 31792-6113 | 2014-12-04 |
| 1225445331 | Gaston Family Health Services Inc | Clinic/Center | 611 Randolph St, Thomasville, NC 27360-5126 | 2014-07-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891395620 | Primary Health Care Center of Dade, Inc. | Clinic/Center | 8a Probasco Street Unit 214, Lafayette, GA 30728 | 2020-10-30 |
| 1366066243 | Health Education Assessment and Leadership Inc | Clinic/Center | 225 Griffin St Nw, Atlanta, GA 30314-3917 | 2020-06-05 |
| 1851924377 | Valley Healthcare System | Clinic/Center | 1458 Benning Dr, Columbus, GA 31903-2200 | 2020-02-13 |
| 1952941528 | Curtis V. Cooper Primary Health Care, Inc | Clinic/Center | 400 E Broad St, Savannah, GA 31401-5104 | 2020-01-13 |
| 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 |
| 1437798725 | Careconnect Health, Inc. | Clinic/Center | 414 S Frontage Rd Lot 53, Forsyth, GA 31029-3025 | 2020-01-03 |
| 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 | ||||
| City | THOMASVILLE |
| Zip Code | 31792 |
Please comment or provide details below to improve the information on PRIMARY CARE OF SOUTHWEST GEORGIA, INC.
| 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.