COLQUITT REGIONAL MEDICAL CENTER (NPI# 1720359326) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720359326 |
| Entity Type | Organization |
| Organization Name | COLQUITT REGIONAL MEDICAL CENTER |
| Other Organization Name | SWING BED |
| Practice Address |
3131 S Main St Moultrie GA 31768-6925 |
| Practice Telephone | 2299853420 |
| Mailing Telephone | 2299853420 |
| Enumeration Date | 2012-01-13 |
| Last Update Date | 2015-05-29 |
| Authorized Official Name | MR. JIM MATNEY (CEO) |
| Authorized Official Telephone | 2299853420 |
| Is Organization Subpart | Y |
| Parent Organization Name | COLQUITT REGIONAL MEDICAL CENTER |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 275N00000X | Medicare Defined Swing Bed Unit | GA | Hospital Units |
| Other Name | Type Code |
|---|---|
| Swing Bed | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912099094 | Colquitt Regional Medical Center | Ambulance | 3131 South Main St, Moultrie, GA 31768-6925 | 2006-09-28 |
| 1720593239 | Colquitt Regional Medical Center | Ambulance | 3131 S Main St, Moultrie, GA 31768-6925 | 2017-12-06 |
| 1962850396 | Colquitt Regional Medical Center | Family Medicine | 1 Magnolia Ct, Moultrie, GA 31768 | 2016-05-26 |
| 1316154834 | Colquitt Regional Medical Center | Hospice Care, Community Based | 2516 5th Ave Se, Moultrie, GA 31788-6207 | 2007-05-16 |
| 1124155965 | Colquitt Regional Medical Center | Clinic/Center | 3131 S Main St, Moultrie, GA 31768-6925 | 2007-02-28 |
| 1881758753 | Colquitt Regional Medical Center | Clinic/Center | 6 Hospital Park, Moultrie, GA 31768-6700 | 2006-12-21 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | COLQUITT REGIONAL MEDICAL CENTER | 3131 S Main St, Moultrie, GA 31768-6925 |
| Street Address |
3131 S MAIN ST |
| City | MOULTRIE |
| State | GA |
| Zip Code | 31768-6925 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255323564 | Dale Mcgregor | Emergency Medicine | 3131 S Main St, Moultrie, GA 31768-6925 | 2005-08-22 |
| 1144861485 | Rebecca Lee Hayes | Nurse Practitioner | 3131 S Main St, Moultrie, GA 31768-6925 | 2019-10-07 |
| 1942865480 | Colquitt Regional Pathology, LLC | Pathology | 3131 S Main St, Moultrie, GA 31768-6925 | 2019-05-09 |
| 1669937264 | Colquitt County Hospital Authority | Pharmacy | 3131 S Main St, Moultrie, GA 31768-6925 | 2019-02-07 |
| 1407331143 | Christopher Neil Medders | Nurse Practitioner | 3131 S Main St, Moultrie, GA 31768-6925 | 2018-09-28 |
| 1255832671 | Alexa Smith | Occupational Therapist | 3131 S Main St, Moultrie, GA 31768-6925 | 2018-02-21 |
| 1346757481 | Jeffery W Roberts | Nurse Anesthetist, Certified Registered | 3131 S Main St, Moultrie, GA 31768-6925 | 2018-01-10 |
| 1720593239 | Colquitt Regional Medical Center | Ambulance | 3131 S Main St, Moultrie, GA 31768-6925 | 2017-12-06 |
| 1689188906 | Mary Ann Waller | Speech-Language Pathologist | 3131 S Main St, Moultrie, GA 31768-6925 | 2017-11-22 |
| 1063923688 | Radiology Associates of Moultrie LLC | Radiology | 3131 S Main St, Moultrie, GA 31768-6925 | 2017-10-23 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356975452 | Zachary Schiffer | Specialist/Technologist | 3131 S Main Street, Moultrie, GA 31768 | 2020-02-27 |
| 1326697731 | Daisy Concierge Care | Nursing Care | 437 S. Morris Rd Lt 1, Moultrie, GA 31768 | 2019-09-09 |
| 1194208751 | Regina Mercer Ward | Nurse Practitioner | 1724 Villa Dr Sw, Moultrie, GA 31768 | 2018-09-10 |
| 1225473630 | Moultrie Orthodontics, P.C. | Clinic/Center | 12 Longleaf Office Park, Moultrie, GA 31768 | 2013-04-30 |
| 1497032239 | Freds Stores of Tennessee Inc | Pharmacy | 2601 South Main Street, Moultrie, GA 31768 | 2011-11-08 |
| 1821382672 | Colquitt Regional Ob/gyn, LLC | Obstetrics & Gynecology | 3 Sweet Bay Ct, Moultrie, GA 31768 | 2011-06-08 |
| 1568779809 | Shana Goodno | Nurse Practitioner | 207 31 St Ave Se, Moultrie, GA 31768 | 2010-09-08 |
| 1508177445 | Cherokee Rose Emergency Physicians | Emergency Medicine | 3131 South Main Street, Moultrie, GA 31768 | 2010-06-25 |
| 1023299963 | Hetal Patel | Counselor | 600 2nd St South East, Moultrie, GA 31768 | 2007-11-20 |
| 1720146756 | William C Byrd Inc | Assisted Living Facility | 498 5th Street Se, Moultrie, GA 31768 | 2006-12-04 |
| Find all providers in zip 31768 | ||||
| Taxonomy Code | 275N00000X |
| Grouping | Hospital Units |
| Classification | Medicare Defined Swing Bed Unit |
| A unit of a hospital that has a Medicare provider agreement and has been granted approval from HCFA to provide post-hospital extended care services and be reimbursed as a swing-bed unit. |
| Notes: Source: Code of Federal Regulations #42, Section 482.66. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437536372 | University Mcduffie County Regional Medical Center, Inc | Medicare Defined Swing Bed Unit | 2460 Washington Road Ne, Thomson, GA 30824-2199 | 2015-04-29 |
| 1588093637 | Premier Healthcare Investments | Medicare Defined Swing Bed Unit | 509 Sumter, Montezuma, GA 31063 | 2013-11-08 |
| 1487817169 | Hosptial Authority of Liberty County | Medicare Defined Swing Bed Unit | 462 Elma G Miles Parkway, Hinesville, GA 31313-4000 | 2008-07-03 |
| 1023287927 | Union County Hospital Authority | Medicare Defined Swing Bed Unit | 35 Hospital Road, Blairsville, GA 30512 | 2008-02-25 |
| 1467663336 | Healthspan LLP | Medicare Defined Swing Bed Unit | 351 Liberty St, Waynesboro, GA 30830-9686 | 2007-05-24 |
| 1548475759 | Putnam General Hospital | Medicare Defined Swing Bed Unit | 101 Lake Oconee Parkway, Eatonton, GA 31024 | 2007-05-11 |
| 1548315898 | Tift Regional Health System, Inc | Medicare Defined Swing Bed Unit | 260 Mj Taylor Rd, Adel, GA 31620-3485 | 2007-01-25 |
| 1063578862 | Taylor Telfair Regional Hospital, Inc | Medicare Defined Swing Bed Unit | Route # 1 Highway 341 South, Mcrae, GA 31055-0150 | 2006-12-28 |
| 1710099098 | Charlton Memorial Hospital | Medicare Defined Swing Bed Unit | 2449 Third St, Folkston, GA 31537-8919 | 2006-08-31 |
| 1881652212 | Pacer Health Corporation of Ga | Medicare Defined Swing Bed Unit | 1201 Siloam Rd, Greensboro, GA 30642-2811 | 2006-05-03 |
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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.