TANNER MEDICAL CENTER, INC. (NPI# 1508842774) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508842774 |
| Entity Type | Organization |
| Organization Name | TANNER MEDICAL CENTER, INC. |
| Other Organization Name | TANNER BEHAVIOR HEALTH INPATIENT UNIT |
| Practice Address |
705 Dixie St Carrollton GA 30117-3818 |
| Practice Telephone | 7708369697 |
| Practice Fax Number | 7708369897 |
| Mailing Telephone | 7708369697 |
| Mailing Fax Number | 7708369897 |
| Enumeration Date | 2005-12-20 |
| Last Update Date | 2007-09-06 |
| Authorized Official Name | MR. LEE C. SHERSETH (CFO) |
| Authorized Official Telephone | 7708369697 |
| Is Organization Subpart | Y |
| Parent Organization Name | TANNER MEDICAL CENTER, INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 273R00000X | Psychiatric Unit | Hospital Units |
| Other Name | Type Code |
|---|---|
| Tanner Behavior Health Inpatient Unit | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033441290 | Tanner Medical Center, Inc. | Counselor | 101 Quartz Dr Ste 103a, Villa Rica, GA 30180-3256 | 2010-02-12 |
| 1104850965 | Tanner Medical Center, Inc. | Prosthetic/Orthotic Supplier | 157 Clinic Ave, Suite 202, Carrollton, GA 30117-4454 | 2006-07-10 |
| 1619953882 | Tanner Medical Center, Inc. | Skilled Nursing Facility | 705 Dixie St, Carrollton, GA 30117-3818 | 2005-12-20 |
| Street Address |
705 DIXIE ST |
| City | CARROLLTON |
| State | GA |
| Zip Code | 30117-3818 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407848799 | Lawrence Brett Carter | Pharmacist | 705 Dixie St, Carrollton, GA 30117-3818 | 2005-08-22 |
| 1760007322 | Crystal Renee Grayson | Nurse Anesthetist, Certified Registered | 705 Dixie St, Carrollton, GA 30117-3818 | 2020-06-10 |
| 1962025361 | Amanda Hasty Mcentyre | Dietitian, Registered | 705 Dixie St, Carrollton, GA 30117-3818 | 2020-05-20 |
| 1265055669 | Purdy Jackson | Dietitian, Registered | 705 Dixie St, Carrollton, GA 30117-3818 | 2020-05-20 |
| 1528681921 | Amanda Phillips Kranz | Dietitian, Registered | 705 Dixie St, Carrollton, GA 30117-3818 | 2020-05-20 |
| 1699396630 | Katherine Victoria White | Nurse Practitioner | 705 Dixie St, Carrollton, GA 30117-3818 | 2020-04-30 |
| 1144866047 | Jennifer Tiffany Jiles | Nurse Practitioner | 705 Dixie St, Carrollton, GA 30117-3818 | 2019-11-26 |
| 1750934733 | Tiffany Landry | Health Educator | 705 Dixie St, Carrollton, GA 30117-3818 | 2019-07-19 |
| 1104479195 | Kim Rowell | Health Educator | 705 Dixie St, Carrollton, GA 30117-3818 | 2019-07-19 |
| 1104478916 | Brandon Gabe Graves | Nurse Anesthetist, Certified Registered | 705 Dixie St, Carrollton, GA 30117-3818 | 2019-07-11 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679199392 | Southern Rad Onc LLC | Radiology | 809 South Park Street, Carrollton, GA 30117 | 2020-06-18 |
| 1093361404 | Eyedeal Eyecare LLC | Optometrist | 1735 S Us 27, Carrollton, GA 30117 | 2019-08-12 |
| 1710412473 | Janis James | Optometrist | 1735 S, Us-27, Walmart Vision Center, Carrollton, GA 30117 | 2017-05-01 |
| 1568881951 | Omar Hajmurad | Anesthesiology | 812 S Park St Ste 5, Carrollton, GA 30117 | 2014-04-14 |
| 1134550353 | Goodbodys Minor Med Express Care | Nurse Practitioner | 1670 South Park St., Carrollton, GA 30117 | 2013-12-13 |
| 1306187570 | Myriam C Vela-ortiz | Internal Medicine | 157 Clinic Ave Ste 203, Carrollton, GA 30117 | 2013-03-12 |
| 1891030201 | Air Evac Ems, Inc. | Ambulance | 827 Old Bremen Rd, Carrollton, GA 30117 | 2012-12-11 |
| 1952682486 | Angelic Wings Transport, Inc. | Non-emergency Medical Transport (VAN) | 362 B Columbia Drive, Carrollton, GA 30117 | 2011-08-29 |
| 1073819256 | Atlanta Prosthetics & Orthotics, Inc. | Durable Medical Equipment & Medical Supplies | 812 South Park Street, Suite 2, Carrollton, GA 30117 | 2011-02-04 |
| 1255640348 | Amy Gilbert | Counselor | 515 Tanner St, Carrollton, GA 30117 | 2010-10-06 |
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| Taxonomy Code | 273R00000X |
| Grouping | Hospital Units |
| Classification | Psychiatric Unit |
| In general, a distinct unit of a hospital that provides acute or long-term care to emotionally disturbed patients, including patients admitted for diagnosis and those admitted for treatment of psychiatric problems on the basis of physicians' orders and approved nursing care plans. Long-term care may include intensive supervision to the chronically mentally ill, mentally disordered or other mentally incompetent persons; (2) For Medicare, a distinct part of a general acute care hospital admitting only patients whose admission to the unit is required for active treatment, whose treatment is of an intensity that can be provided only in an inpatient hospital setting, and whose condition is described by a psychiatric principal diagnosis contained in the Third Edition of the American Psychiatric Association Diagnostic and Statistical Manual or in Chapter 5 (Mental Disorders) of the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM). The unit must furnish, through the use of qualified personnel, psychological services, social work services, psychiatric nursing, occupational therapy, and recreational therapy. The unit must maintain medical records that permit determination of the degree and intensity of treatment provided to individuals who are furnished services in the unit; the unit must meet special staff requirements in that the unit must have adequate numbers of qualified professional and supportive staff to evaluate inpatients, formulate written, individualized, comprehensive treatment plans, provide active treatment measures and engage in discharge planning. |
| Notes: Source: (1) AHA Annual Survey p. A10 1996 AHA Guide; (2) Code of Federal Regulations #42, Section 412.27. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316290430 | Pickens County Health Care Authority | Psychiatric Unit | 241 Robert K Wilson Drive, Carrollton, AL 35447-0478 | 2012-10-26 |
| 1992793046 | Pickens County Medical Center, Inc | Psychiatric Unit | 241 Robert K Wilson Dr, Carrollton, AL 35447-8010 | 2005-10-12 |
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|---|---|---|---|---|
| 1922230648 | Peachstate Psychiatric Services, Inc. | Psychiatric Unit | 1720 Peachtree St Nw Ste 640, Atlanta, GA 30309-2450 | 2009-08-13 |
| 1982634572 | Gwinnett Hospital System, Inc. | Psychiatric Unit | 250 Scenic Hwy, Lawrenceville, GA 30045-5675 | 2006-07-03 |
| 1730123431 | John D. Archbold Memorial Hospital, Inc. | Psychiatric Unit | 401 Old Albany Rd, Thomasville, GA 31792-4014 | 2006-06-15 |
| 1023057775 | Floyd Healthcare Management Inc | Psychiatric Unit | 306 Shorter Ave Nw, Rome, GA 30165-4268 | 2006-06-06 |
| 1760436810 | Coliseum Medical Center, LLC | Psychiatric Unit | 340 Hospital Drive, Macon, GA 31217 | 2006-05-22 |
| 1902453111 | Sedzer Health LLC | Psychiatric Unit | 931 E Winthrope Ave, Millen, GA 30442-1839 | 2019-08-22 |
| 1578026431 | South Atlanta Psychiatry LLC | Psychiatric Unit | 253 Upper Riverdale Rd Sw Ste C, Riverdale, GA 30274-4945 | 2019-04-08 |
| 1518440254 | Prime Healthcare Foundation - Southern Regional, LLC | Psychiatric Unit | 11 Upper Riverdale Rd Sw, Riverdale, GA 30274-2615 | 2018-09-10 |
| 1831602903 | Savannah Health Services, LLC | Psychiatric Unit | 4700 Waters Ave, Savannah, GA 31404-6220 | 2017-11-13 |
| 1225559610 | Upson County Hospital Inc | Psychiatric Unit | 801 W Gordon St, Thomaston, GA 30286-3426 | 2017-07-06 |
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| City | CARROLLTON |
| Zip Code | 30117 |
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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.