PALMETTO HEALTH COUNCIL INC (NPI# 1740372473) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1740372473 |
| Entity Type | Organization |
| Organization Name | PALMETTO HEALTH COUNCIL INC |
| Other Organization Name | COMMUNITY MEDICAL CENTER |
| Practice Address |
643 Main St Palmetto GA 30268-1138 |
| Practice Telephone | 4049298824 |
| Practice Fax Number | 4049299769 |
| Mailing Telephone | 4049298824 |
| Mailing Fax Number | 4049299769 |
| Enumeration Date | 2006-09-29 |
| Last Update Date | 2013-06-05 |
| Authorized Official Name | DR. JON WILLIAM WOLLENZIEN (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Telephone | 4049298824 |
| Authorized Official Credential | PHD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
H800040 | GA | Ambulatory Health Care Facilities |
| Y | 207Q00000X | Family Medicine | H800040 | GA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 000472128F | 05 | |
| GA | 000472128G | 05 | |
| GA | 931512872A | 05 | |
| GA | 000472128E | 05 | |
| GA | 000228379A | 05 | |
| GA | 000472128A | 05 | |
| GA | 000472128H | 05 |
| Other Name | Type Code |
|---|---|
| Community Medical Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629238126 | Palmetto Health Council Inc | Family Medicine | 200 North Hwy # 29, Hogansville, GA 30230-1142 | 2008-06-10 |
| 1134344732 | Palmetto Health Council Inc | Family Medicine | 16201 Barnesville St, Zebulon, GA 30295-3380 | 2007-04-17 |
| 1467612952 | Palmetto Health Council Inc | Family Medicine | 202 Croft St, Carrollton, GA 30117-3803 | 2008-06-10 |
| 1164682662 | Palmetto Health Council Inc | Family Medicine | 101 Commerce Pl, Suite 1, Barnesville, GA 30204-1680 | 2008-06-10 |
| 1184884678 | Palmetto Health Council Inc | Family Medicine | 643 Main St, Palmetto, GA 30268-1138 | 2008-06-10 |
| Street Address |
643 MAIN ST |
| City | PALMETTO |
| State | GA |
| Zip Code | 30268-1138 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750388906 | Hector J. Viera | Dentist | 643 Main St, Palmetto, GA 30268-1138 | 2005-07-01 |
| 1730674045 | Elizabeth Maria Zarantonello | Nurse Practitioner | 643 Main St, Palmetto, GA 30268-1138 | 2018-06-28 |
| 1699167684 | Ashleigh Elise Heath | Nurse Practitioner | 643 Main St, Palmetto, GA 30268-1138 | 2015-02-27 |
| 1528322922 | Gabriela Pena | Family Medicine | 643 Main St, Palmetto, GA 30268-1138 | 2012-06-29 |
| 1447561501 | Adam Joseph Barefoot | Dentist | 643 Main St, Palmetto, GA 30268-1138 | 2010-06-23 |
| 1437488426 | Palmetto Health Council, Inc. | Pharmacy | 643 Main St, Palmetto, GA 30268-1138 | 2009-12-22 |
| 1184884678 | Palmetto Health Council Inc | Family Medicine | 643 Main St, Palmetto, GA 30268-1138 | 2008-06-10 |
| 1215157060 | Frederick Moore | Dentist | 643 Main St, Palmetto, GA 30268-1138 | 2007-04-26 |
| 1942424221 | Nasser Issa Fiqia | Dentist | 643 Main St, Palmetto, GA 30268-1138 | 2007-04-11 |
| 1609944917 | Milanieva Latorre | Family Medicine | 643 Main St, Palmetto, GA 30268-1138 | 2006-12-04 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013521491 | Hla Ambulance LLC | Ambulance | 43 Amanda Ln, Palmetto, GA 30268 | 2020-09-03 |
| 1134779424 | Center for Positive Change LLC | Counselor | 11207 Serenbe Lane, Hills, GA 30268 | 2019-09-18 |
| 1336397868 | Key David Mcmurrain Jr. | Preventive Medicine | 10180 Capps Ferry Road, Palmetto, GA 30268 | 2008-09-09 |
| 1548333115 | Carolyn E Johnson | Registered Nurse | 507 Park Street, Palmetto, GA 30268 | 2006-11-15 |
| 1386710796 | Gary Lane Watts | Dentist | 501 Park St, Palmetto, GA 30268-1007 | 2006-11-28 |
| 1285707455 | Angela P. Shannon | Psychiatry & Neurology | 507 Park St, Palmetto, GA 30268-1007 | 2006-11-16 |
| 1952967234 | Palmetto Health Council, Inc. | Clinic/Center | 507 Park St, Palmetto, GA 30268-1007 | 2019-05-13 |
| 1447791835 | Lyzette Santiago Rodriguez | Counselor | 507 Park St, Palmetto, GA 30268-1007 | 2017-03-17 |
| 1841580560 | Palmetto Family Dental, PC | Dentist | 501 Park St, Palmetto, GA 30268-1007 | 2011-04-14 |
| 1861631053 | Jordan Albert Brunson | Dentist | 501 Park St, Palmetto, GA 30268-1007 | 2009-02-11 |
| Find all providers in zip 30268 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699318840 | Palmetto Primary Care Associates, LLC | Family Medicine | 1003 17th St W, Palmetto, FL 34221-3021 | 2019-10-21 |
| 1326465410 | Allcare Options LLC | Family Medicine | 700 8th Ave W, Suite 101, Palmetto, FL 34221-4737 | 2014-03-26 |
| 1073771762 | Jacqueline D Harris | Family Medicine | 815 Weldon Rd, Palmetto, GA 30268-1667 | 2008-05-29 |
| 1669668273 | Diamond Family Medicine Pllc Donita Kay Diamond Sole Mbr | Family Medicine | 102 Riviera Dunes Way, Palmetto, FL 34221 | 2007-09-18 |
| 1104968783 | Kevin Brian Fox | Family Medicine | 9490 Highway 10, Palmetto, LA 71358-0219 | 2007-02-12 |
| 1851369052 | Steven Lewis Greenfield | Family Medicine | 404 7th St W, Palmetto, FL 34221-5209 | 2006-03-14 |
| 1366416190 | Coleen Ann Ellis | Family Medicine | 1120 10th St E, Palmetto, FL 34221-4134 | 2006-02-16 |
| 1194722983 | James A Briles | Family Medicine | 606 4th Ave W, Palmetto, FL 34221-5226 | 2005-07-07 |
| 1558368423 | Raymond L Raitz | Family Medicine | 506 4th Ave W, Palmetto, FL 34221-5203 | 2005-07-06 |
| 1740823582 | Mcr Health, Inc. | Family Medicine | 700 8th Ave W Ste 101, Palmetto, FL 34221-4737 | 2019-10-24 |
| Find all providers in PALMETTO | ||||
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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.