BACON COUNTY HEALTH SERVICES, INC. (NPI# 1558898882) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558898882 |
| Entity Type | Organization |
| Organization Name | BACON COUNTY HEALTH SERVICES, INC. |
| Other Organization Name | NICHOLLS FAMILY HEALTHCARE |
| Practice Address |
1205 Van Streat Hwy Nicholls GA 31554 |
| Mailing Address |
302 S Wayne St Alma GA 31510-2922 |
| Practice Telephone | 9126322952 |
| Mailing Telephone | 9126328961 |
| Mailing Fax Number | 9126325000 |
| Enumeration Date | 2017-05-17 |
| Last Update Date | 2018-05-22 |
| Authorized Official Name | MRS. CINDY TURNER (CEO) |
| Authorized Official Telephone | 9126328961 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 282NR1301X |
General Acute Care Hospital Specialization: Rural |
Hospitals | ||
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
Physician Assistants & Advanced Practice Nursing Providers |
| Other Name | Type Code |
|---|---|
| Nicholls Family Healthcare | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639485394 | Bacon County Health Services, Inc. | Orthopaedic Surgery | 205 S Wayne St, Alma, GA 31510-2919 | 2010-08-19 |
| 1912111634 | Bacon County Health Services, Inc. | Skilled Nursing Facility | 301 S Baker St, Alma, GA 31510-3019 | 2007-05-10 |
| 1720302292 | Bacon County Health Services, Inc. | Orthopaedic Surgery | 2003 Alice St, Ste A, Waycross, GA 31501-6209 | 2010-03-26 |
| 1245446699 | Bacon County Health Services, Inc. | Medicare Defined Swing Bed Unit | 302 S Wayne St, Alma, GA 31510-2922 | 2007-05-15 |
| 1629185285 | Bacon County Health Services, Inc. | General Acute Care Hospital | 302 S Wayne St, Alma, GA 31510-2922 | 2006-08-23 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | BACON COUNTY HEALTH SERVICES, INC. | 302 S Wayne St, Alma, GA 31510-2922 |
| Street Address |
1205 VAN STREAT HWY |
| City | NICHOLLS |
| State | GA |
| Zip Code | 31554 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285677872 | Pamela C. Lee | Nurse Practitioner | 1205 Van Streat Hwy, Nicholls, GA 31554-5025 | 2006-06-13 |
| 1306021795 | Nicholls Family Health Care, P.C. | Clinic/Center | 1205 Van Streat Hwy, Nicholls, GA 31554-5025 | 2008-01-03 |
| 1649378506 | Jose Ramon Castro | Family Medicine | 1205 Van Streat Hwy, Nicholls, GA 31554-5025 | 2006-09-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295095925 | Crh Physician Practices LLC | Clinic/Center | 804 N Liberty St, Nicholls, GA 31554 | 2012-05-29 |
| 1083846554 | Ashley Miller | Dentist | 1153 N Liberty St, Nicholls, GA 31554 | 2009-08-18 |
| 1508913278 | Sheila Lynette Taylor | Contractor | 117 Aspen Road, Nicholls, GA 31554 | 2007-01-04 |
| 1457460198 | Nicholls Pharmacy | Pharmacist | 1003 Van Streat Hwy, Nicholls, GA 31554 | 2006-08-29 |
| 1174639959 | Brad M Mobley | Pharmacist | 1003 Van Streat Highway, Nicholls, GA 31554 | 2006-08-22 |
| 1760817795 | Healthstat On-site Clinic/milliken Alma | Preventive Medicine | 2410 Ga Highway 32 W, Nicholls, GA 31554-3446 | 2013-09-10 |
| 1922161033 | Myra Sellers | Speech-Language Pathologist | 105 Cherrywood Dr, Nicholls, GA 31554-3505 | 2006-12-19 |
| 1669418711 | Nicholls Clinic | Public Health or Welfare | 806 N Liberty St, Nicholls, GA 31554-4006 | 2006-06-20 |
| 1831568724 | Latasha Nicole Gilliard | Nurse Practitioner | 7171 Nails Rd, Nicholls, GA 31554-4613 | 2015-09-21 |
| 1184748808 | Nicholls Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 1003 Van Streat Hwy, Nicholls, GA 31554-5031 | 2007-03-19 |
| Find all providers in zip 31554 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831568724 | Latasha Nicole Gilliard | Nurse Practitioner | 7171 Nails Rd, Nicholls, GA 31554-4613 | 2015-09-21 |
| 1285677872 | Pamela C. Lee | Nurse Practitioner | 1205 Van Streat Hwy, Nicholls, GA 31554-5025 | 2006-06-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780285486 | Aprn Mobile Clinic LLC | Nurse Practitioner | 1361 Highwoods Pass, Grovetown, GA 30813-3994 | 2020-11-08 |
| 1093316820 | Odyne Rose Lacossiere-dorvilus | Nurse Practitioner | 30 Myrtlewood Dr, Savannah, GA 31405-1024 | 2020-11-06 |
| 1104427061 | Tya Wright | Nurse Practitioner | 1450 Newnan Crossing Blvd E Apt 13205, Newnan, GA 30265-0027 | 2020-11-05 |
| 1235730409 | Cheryl Lynn Williams | Nurse Practitioner | 282 Somerset Dr, Dallas, GA 30132-9761 | 2020-11-04 |
| 1033710298 | Karen F Frazier | Nurse Practitioner | 6610 Crest Wood Ln, Douglasville, GA 30135-9046 | 2020-11-04 |
| 1619578986 | Marjorie Sewannyana | Nurse Practitioner | 553 Camano Way, Mcdonough, GA 30253-8377 | 2020-11-03 |
| 1639770027 | Markesha Leshea Groomes | Nurse Practitioner | 209 N. Cuthbert, Colquitt, GA 39837-3515 | 2020-11-03 |
| 1265033625 | Ashley Thomas | Nurse Practitioner | 3750 Venture Dr Ste E4, Duluth, GA 30096-1863 | 2020-11-03 |
| 1558962894 | Anna Marie Kodama | Nurse Practitioner | 462 Furys Ferry Rd # C, Augusta, GA 30907-9506 | 2020-11-03 |
| 1093315848 | Tracy Tarvers | Nurse Practitioner | 129 Wolf Creek Dr N, Macon, GA 31210-9002 | 2020-10-30 |
| 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.