WELLSTAR SYLVAN GROVE HOSPITAL, INC (NPI# 1619997079) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619997079 |
| Entity Type | Organization |
| Organization Name | WELLSTAR SYLVAN GROVE HOSPITAL, INC |
| Other Organization Name | WELLSTAR SYLVAN GROVE HOSPITAL |
| Practice Address |
1050 Mcdonough Rd Jackson GA 30233-1524 |
| Mailing Address |
1800 Parkway Pl Se Ste 500 Marietta GA 30067-8237 |
| Practice Telephone | 7707757861 |
| Mailing Telephone | 4709564981 |
| Mailing Fax Number | 7709992489 |
| Enumeration Date | 2006-07-20 |
| Last Update Date | 2020-02-24 |
| Authorized Official Name | MR. ANTHONY J BUDZINSKI (EVP) |
| Authorized Official Telephone | 4706440012 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 282NC0060X |
General Acute Care Hospital Specialization: Critical Access |
018-544 | GA | Hospitals |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 000001856A | 05 |
| Other Name | Type Code |
|---|---|
| WellStar Sylvan Grove Hospital | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386664779 | Wellstar Sylvan Grove Hospital, Inc | General Acute Care Hospital | 1050 Mcdonough Rd, Jackson, GA 30233-1524 | 2006-07-20 |
| Street Address |
1050 MCDONOUGH RD |
| City | JACKSON |
| State | GA |
| Zip Code | 30233-1524 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144260878 | John Sanford Evans | Emergency Medicine | 1050 Mcdonough Rd, Jackson, GA 30233-1524 | 2006-06-08 |
| 1992350607 | Adam Edenfield | Physical Therapist | 1050 Mcdonough Rd, Jackson, GA 30233-1524 | 2019-08-08 |
| 1477030971 | Michele A Lucien | Physical Therapy Assistant | 1050 Mcdonough Rd, Jackson, GA 30233-1524 | 2018-07-26 |
| 1629555826 | Tejal Janak Patel I | Physical Therapist | 1050 Mcdonough Rd, Jackson, GA 30233-1599 | 2018-07-20 |
| 1831329663 | Serah Iyabode Ayoola | Physical Therapist | 1050 Mcdonough Rd, Jackson, GA 30233-1524 | 2009-07-14 |
| 1881862431 | Maja N. Lee | Registered Nurse | 1050 Mcdonough Rd, Jackson, GA 30233-1524 | 2008-02-18 |
| 1912031550 | Hannah Whitfield | Speech-Language Pathologist | 1050 Mcdonough Rd, Jackson, GA 30233-1524 | 2007-03-15 |
| 1669513966 | Erin Downing | Speech-Language Pathologist | 1050 Mcdonough Rd, Jackson, GA 30233-1524 | 2007-02-09 |
| 1053466151 | Jessica Rosser | Physical Therapy Assistant | 1050 Mcdonough Rd, Jackson, GA 30233-1524 | 2007-01-25 |
| 1992857320 | Amanda Keese | Physical Therapy Assistant | 1050 Mcdonough Rd, Jackson, GA 30233-1524 | 2007-01-17 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366800914 | Georgia Ophthalmologists LLC | Durable Medical Equipment & Medical Supplies | 860 W 3rd St, Jackson, GA 30233 | 2016-02-10 |
| 1306225057 | Young Dreaden | Nurse Practitioner | 2978 Hwy 36w, Jackson, GA 30233 | 2015-05-28 |
| 1609255520 | Neta J Roby | Nurse Practitioner | Hwy 36, Georgia Diagnostic Classification Prison, Jackson, GA 30233 | 2015-05-26 |
| 1033546098 | Henrietta Lindsay | Social Worker | 463-b Ernest Biles Dr, Jackson, GA 30233 | 2013-10-04 |
| 1255776993 | Gareth Gene Walker | Technician | 514 Covinton Street, Jackson, GA 30233 | 2013-05-08 |
| 1730489592 | Mary L. Melton | Licensed Practical Nurse | 463 Ernest Biles Dr., Jackson, GA 30233 | 2010-10-27 |
| 1083864250 | Chastity Moore Brown | Dentist | 1520 Lucky Street, Griffin, GA 30233 | 2008-09-24 |
| 1568661320 | Joseph Fowlkes | Internal Medicine | 2978 Highway 36 W, Jackson, GA 30233 | 2007-07-12 |
| 1942386289 | Butts County Board of Commissioners | Ambulance | 154 Sylvan Drive, Jackson, GA 30233 | 2006-10-30 |
| 1841238300 | Jackson Pharmacy Services | Pharmacy | 22 Mulberry St., Jackson, GA 30233 | 2006-06-04 |
| Find all providers in zip 30233 | ||||
| Taxonomy Code | 282NC0060X |
| Grouping | Hospitals |
| Classification | General Acute Care Hospital |
| Specialization | Critical Access |
| Definition to come. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295987303 | Umc Medical Center | General Acute Care Hospital | 2500 N State St, Jackson, MS 39216-4500 | 2008-10-21 |
| 1487858452 | University of Mississippi Medical Center | General Acute Care Hospital | 2500 N State St, Jackson, MS 39216-4500 | 2007-06-13 |
| 1154541415 | University Preventive Medicine | General Acute Care Hospital | 2500 N State St, Jackson, MS 39216-4500 | 2007-04-27 |
| 1811901531 | Sanford Health Network | General Acute Care Hospital | 1430 North Hwy, Jackson, MN 56143-1093 | 2006-07-28 |
| 1326069097 | Sanford Health Network | General Acute Care Hospital | 1430 North Hwy, Jackson, MN 56143-1093 | 2006-07-21 |
| 1386664779 | Wellstar Sylvan Grove Hospital, Inc | General Acute Care Hospital | 1050 Mcdonough Rd, Jackson, GA 30233-1524 | 2006-07-20 |
| 1750306437 | Jackson Madison County General Hospital | General Acute Care Hospital | 708 W Forest Ave, Jackson, TN 38301-3901 | 2006-07-13 |
| 1992720676 | Jackson Madison County General Hospital | General Acute Care Hospital | 708 W Forest Ave, Jackson, TN 38301-3901 | 2006-07-13 |
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|---|---|---|---|---|
| 1780046425 | Rasheeda Brown | General Acute Care Hospital | 362 E.g. Miles Parkway, Hinesville, GA 31310-0919 | 2016-03-22 |
| 1073927117 | Polk Medical Center, Inc | General Acute Care Hospital | 2360 Rockmart Hwy, Cedartown, GA 30125-6029 | 2014-06-17 |
| 1174800114 | Emory University Hospital | General Acute Care Hospital | 1355 Clifton Rd Ne, Atlanta, GA 30322-1013 | 2011-11-04 |
| 1013211564 | Grady Health System | General Acute Care Hospital | 180 Victoria Dr, Fayetteville, GA 30214-1163 | 2010-12-26 |
| 1417264292 | Angela Marie Barco | General Acute Care Hospital | 3486 Peach Orchard Rd Ste 200, Augusta, GA 30906 | 2010-09-01 |
| 1780880583 | Wheeler County Hospital | General Acute Care Hospital | 111 North 3rd Street, Glenwood, GA 30428 | 2007-06-27 |
| 1609078047 | Medical College of Georgia | General Acute Care Hospital | 1120 15th St # Baa-5407, Augusta, GA 30912-0004 | 2007-06-05 |
| 1982821971 | Carl Vison Va Medical Center | General Acute Care Hospital | 48 Blueberry Farm Road, Adrian, GA 31002 | 2007-04-19 |
| 1326191180 | Professional Resources Management of Rabun, LLC | General Acute Care Hospital | 162 Legacy Pt, Clayton, GA 30525-5354 | 2007-01-18 |
| 1184771586 | Lower Oconee Community Hospital Inc | General Acute Care Hospital | 111 N 3rd Street, P O Bx 398, Glenwood, GA 30428 | 2007-01-05 |
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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.