TATTNALL HOSPITAL COMPANY, LLC (NPI# 1790942381) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790942381 |
| Entity Type | Organization |
| Organization Name | TATTNALL HOSPITAL COMPANY, LLC |
| Other Organization Name | OPTIM MEDICAL CENTER - TATTNALL |
| Practice Address |
247 S Main St Reidsville GA 30453-4605 |
| Mailing Address |
Po Box 102764 Atlanta GA 30368-2764 |
| Practice Telephone | 9125571000 |
| Practice Fax Number | 9125571009 |
| Mailing Telephone | 9125571000 |
| Mailing Fax Number | 9125571009 |
| Enumeration Date | 2008-05-21 |
| Last Update Date | 2015-07-24 |
| Authorized Official Name | MR. ROBERT GUENTHNER (SECRETARY OF COMM. HOSP. HOLD. CO.) |
| Authorized Official Telephone | 3126278427 |
| Is Organization Subpart | Y |
| Parent Organization Name | TATTNALL HOSPITAL COMPANY LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 282NC0060X |
General Acute Care Hospital Specialization: Critical Access |
132601 | GA | Hospitals |
| Y | 282NC0060X |
General Acute Care Hospital Specialization: Critical Access |
Hospitals |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 000001878A | 05 |
| Other Name | Type Code |
|---|---|
| Optim Medical Center - Tattnall | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912566811 | Tattnall Hospital Company, LLC | Clinic/Center | 10200 Ford Ave Ste 105, Richmond Hill, GA 31324-8824 | 2019-06-13 |
| 1285132415 | Tattnall Hospital Company, LLC | Family Medicine | 380a Cedar St, Metter, GA 30439 | 2018-01-23 |
| 1558878884 | Tattnall Hospital Company, LLC | Neurological Surgery | 242 Industrial Blvd, Dublin, GA 31021 | 2018-01-09 |
| 1093115123 | Tattnall Hospital Company, LLC | Neurological Surgery | 3345 Us Highway 84, Suite 100, Blackshear, GA 31516-2159 | 2014-08-26 |
| 1790112571 | Tattnall Hospital Company, LLC | Surgery | 1702-a Meadows Lane, Vidalia, GA 30474 | 2013-10-10 |
| 1720322464 | Tattnall Hospital Company, LLC | Orthopaedic Surgery | 38 S. Tallahassee Street, Suite B, Hazlehurst, GA 31539 | 2012-11-19 |
| 1013261312 | Tattnall Hospital Company, LLC | Physical Medicine & Rehabilitation | 8. North Williams Street, Metter, GA 30439 | 2012-11-08 |
| 1245501063 | Tattnall Hospital Company, LLC | Physical Medicine & Rehabilitation | 5918 Ogeechee Rd, Savannah, GA 31419-9527 | 2012-01-25 |
| 1154614360 | Tattnall Hospital Company, LLC | Family Medicine | 1811 Edwina Drive, Vidalia, GA 30474 | 2011-05-20 |
| 1891009924 | Tattnall Hospital Company, LLC | Orthopaedic Surgery | 110 East Tollison Street, Baxley, GA 31513 | 2010-07-30 |
| Street Address |
247 S MAIN ST |
| City | REIDSVILLE |
| State | GA |
| Zip Code | 30453-4605 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679520217 | Tattnall Emergency Physicians, LLC | Emergency Medicine | 247 S Main St, Emergency Department, Reidsville, GA 30453-4605 | 2006-05-28 |
| 1558979591 | Vincent John R Busante | Occupational Therapist | 247 S Main St, Reidsville, GA 30453-4605 | 2020-07-15 |
| 1659922722 | Carol Ann Alexander | Nurse Practitioner | 247 S Main St, Reidsville, GA 30453-4605 | 2019-09-20 |
| 1295151975 | Ashley Nicole Vaughan | Occupational Therapist | 247 S Main St, Reidsville, GA 30453-4605 | 2014-03-05 |
| 1962748368 | Mark Spivey Orthopedic Clinic LLC | Orthopaedic Surgery | 247 S Main St, Reidsville, GA 30453-4605 | 2012-12-13 |
| 1114261047 | Clayborne Fulchi | Nurse Anesthetist, Certified Registered | 247 S Main St, Reidsville, GA 30453-4605 | 2012-11-15 |
| 1932489481 | Natalie Pippin Britt | Emergency Medicine | 247 S Main St, Reidsville, GA 30453 | 2011-08-27 |
| 1144550716 | Chasity Carter Mcneal | Occupational Therapist | 247 S Main St, Reidsville, GA 30453-4605 | 2010-01-05 |
| 1740440932 | Tattnall Hospital Company LLC | Medicare Defined Swing Bed Unit | 247 S Main St, Reidsville, GA 30453-4605 | 2008-06-11 |
| 1487821674 | The Tattnall Bank | General Acute Care Hospital | 247 S Main St, Reidsville, GA 30453-4605 | 2008-05-15 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659990869 | Katrina A Toler | Specialist/Technologist, Other | Optim Medical Center - Tattnall, 247 S Main Street, Reidsville, GA 30453 | 2020-04-09 |
| 1548750110 | Benjamin Addril Clark | Pharmacist | Se Regional Pharmacy Attn: Ben Clark, 300 First Avenue South, Reidsville, GA 30453 | 2018-05-18 |
| 1770824351 | Elite Care Dme,llc | Durable Medical Equipment & Medical Supplies | 123 S. Main St., Reidsville, GA 30453 | 2013-03-07 |
| 1003154766 | Rebekah Hollis Parker | Occupational Therapist | 247 A South Main Street, Reidsville, GA 30453 | 2013-01-30 |
| 1629359419 | D. Wilson Inc. | Durable Medical Equipment & Medical Supplies | 121 South Main Street Unit A, Reidsville, GA 30453 | 2011-09-07 |
| 1417278029 | Tattnall Community Ems | Ambulance | 194 John O Parker Dr., Reidsville, GA 30453 | 2010-06-17 |
| 1518122563 | Brenda Marie Black | Licensed Practical Nurse | 150 Memorial Drive, 150 Memorial Drive, Reidsville, GA 30453 | 2008-07-18 |
| 1063694404 | Ihori Kameyama | Counselor | 150 Memorial Dr., Reidsville, GA 30453 | 2007-11-28 |
| 1710947403 | Donald Franklin Kennedy Jr. | Specialist | 131 Memorial Drive, Reidsville, GA 30453 | 2006-03-25 |
| 1801438676 | Olive Care Durable Medical & Supplies, LLC. | Durable Medical Equipment & Medical Supplies | 123 S. Main St., Reidsville, GA 30453 | 2019-10-14 |
| Find all providers in zip 30453 | ||||
| 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 |
|---|---|---|---|---|
| 1487821674 | The Tattnall Bank | General Acute Care Hospital | 247 S Main St, Reidsville, GA 30453-4605 | 2008-05-15 |
| 1538336045 | The Tattnall Bank | General Acute Care Hospital | 247 S Main St, Reidsville, GA 30453-4605 | 2008-05-14 |
| 1548471337 | Tattnall Community Hospital | General Acute Care Hospital | 247 S Main St, Reidsville, GA 30453-4605 | 2007-05-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 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 |
| Find all providers with the same taxonomy | ||||
| City | REIDSVILLE |
| Zip Code | 30453 |
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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.