MCKINNEY MEDICAL CENTER INC (NPI# 1578822433) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578822433 |
| Entity Type | Organization |
| Organization Name | MCKINNEY MEDICAL CENTER INC |
| Other Organization Name | MCKINNEY COMMUNITY HEALTH CENTER |
| Practice Address |
935 Mcdonald St Waycross GA 31501-4651 |
| Mailing Address |
218 Quarterman St Waycross GA 31501-3547 |
| Practice Telephone | 9122855080 |
| Practice Fax Number | 9122871568 |
| Mailing Telephone | 9122870301 |
| Mailing Fax Number | 9122871568 |
| Enumeration Date | 2012-05-14 |
| Last Update Date | 2019-06-05 |
| Authorized Official Name | OLA SMITH (CEO) |
| Authorized Official Telephone | 9122870301 |
| Authorized Official Credential | CEO |
| Is Organization Subpart | Y |
| Parent Organization Name | MCKINNEY MEDICAL CENTER 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 |
| Other Name | Type Code |
|---|---|
| Mckinney Community Health Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871756049 | Mckinney Medical Center Inc | Clinic/Center | 9355 South Main Street, Nahunta, GA 31553-9806 | 2008-07-08 |
| 1801057690 | Mckinney Medical Center Inc | Clinic/Center | 3919 Main St, Folkston, GA 31537-7545 | 2008-06-24 |
| 1487665733 | Mckinney Medical Center Inc | Clinic/Center | 218 Quarterman St, Waycross, GA 31501 | 2006-08-11 |
| 1821476193 | Mckinney Medical Center Inc | Clinic/Center | 711 Charles Gilman Jr Ave Ste B, Kingsland, GA 31548-5664 | 2015-05-07 |
| 1134454911 | Mckinney Medical Center Inc | Clinic/Center | 501 N Pierce St, Alma, GA 31510-2445 | 2009-10-12 |
| Street Address |
935 MCDONALD ST |
| City | WAYCROSS |
| State | GA |
| Zip Code | 31501-4651 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962906115 | Davenport Health Pa | Family Medicine | 1401 Cherokee Drive, Waycross, GA 31501 | 2018-03-22 |
| 1962940478 | Blake Darren Aldridge | Physical Therapy Assistant | 401 Preston Street, Waycross, GA 31501 | 2017-02-03 |
| 1669922142 | Jebediah S. Christy Dds - Waycross Pllc | Dentist | 2271 Memorial Dr, Waycross, GA 31501 | 2016-10-10 |
| 1558721944 | Jana Kirby | Massage Therapist | 1599 Knight Ave., Kallman Chiropractic Center, Waycross, GA 31501 | 2016-02-29 |
| 1962877001 | Courtney Baldwin | Specialist/Technologist, Other | 2403 Spurgeon St, Waycross, GA 31501 | 2015-12-01 |
| 1912389784 | Grayson Stuart Griffis | Dentist | 2103 Tebeau St., Waycross, GA 31501 | 2015-06-29 |
| 1730561267 | Trishla Amit Desai | Internal Medicine | Memorial Satilla Health, 1900 Tebeau Street, Waycross, GA 31501 | 2015-06-20 |
| 1316330913 | Hanger Prosthetics & Orthotics, Inc. | Prosthetic/Orthotic Supplier | 512 City Blvd Ste H, Waycross, GA 31501 | 2015-03-06 |
| 1942699079 | Jose Ramon Martinez | Anesthesiology | 701 City Blvd, Waycross, GA 31501 | 2015-01-13 |
| 1023356714 | Orthopedics Surgeons of Georgia, LLC | Orthopaedic Surgery | 2015 Alice Street, Waycross, GA 31501 | 2013-01-30 |
| Find all providers in zip 31501 | ||||
| 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 |
|---|---|---|---|---|
| 1487665733 | Mckinney Medical Center Inc | Clinic/Center | 218 Quarterman St, Waycross, GA 31501 | 2006-08-11 |
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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 |
| 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 |
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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.