MCKINNEY MEDICAL CENTER INC (NPI# 1801057690) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1801057690 |
| Entity Type | Organization |
| Organization Name | MCKINNEY MEDICAL CENTER INC |
| Other Organization Name | MCKINNEY COMMUNITY HEALTH CENTER |
| Practice Address |
3919 Main St Folkston GA 31537-7545 |
| Mailing Address |
218 Quarterman St Waycross GA 31501-3547 |
| Practice Telephone | 9124963426 |
| Practice Fax Number | 9122871568 |
| Mailing Telephone | 9122870301 |
| Mailing Fax Number | 9122870687 |
| Enumeration Date | 2008-06-24 |
| Last Update Date | 2019-06-05 |
| Authorized Official Name | OLA SMITH (CEO) |
| Authorized Official Telephone | 9122870301 |
| 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) |
111908 | GA | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | AMERIGROUP | 10066125 | 01 |
| GA | 000715415E | 05 | |
| GA | WELLCARE | 336243 | 01 |
| Other Name | Type Code |
|---|---|
| Mckinney Community Health Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578822433 | Mckinney Medical Center Inc | Clinic/Center | 935 Mcdonald St, Waycross, GA 31501-4651 | 2012-05-14 |
| 1871756049 | Mckinney Medical Center Inc | Clinic/Center | 9355 South Main Street, Nahunta, GA 31553-9806 | 2008-07-08 |
| 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 |
3919 MAIN ST |
| City | FOLKSTON |
| State | GA |
| Zip Code | 31537-7545 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407486954 | Jennifer Nicole Clairday | Nurse Practitioner | 3919 Main St, Folkston, GA 31537-7545 | 2020-01-23 |
| 1700341518 | Marcus Allen Bowen | Nurse Practitioner | 3919 Main St, Folkston, GA 31537-7545 | 2019-02-06 |
| 1801182100 | James Cutia | Nurse Practitioner | 3919 Main St, Folkston, GA 31537-7545 | 2011-06-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124390216 | Charlton Cs | Day Training, Developmentally Disabled Services | 3010 Homeland Park Rd, Folkston, GA 31537 | 2012-02-03 |
| 1962549253 | Unison Behavioral Health | Day Training, Developmentally Disabled Services | Rr 1 Box 3010, Folkston, GA 31537 | 2007-01-30 |
| 1922018159 | Albert Marion Thompson Jr. | Family Medicine | 1203 N 3rd St, Folkston, GA 31537-0188 | 2006-08-09 |
| 1063413706 | Ghislain Richard Perron | Family Medicine | 1001 N 3rd St, Folkston, GA 31537-1301 | 2005-08-03 |
| 1760419063 | Heather G Peebles | Dietitian, Registered | 1209 N 3rd St, Folkston, GA 31537-1303 | 2006-06-26 |
| 1619979812 | Hal London | Emergency Medicine | 1203 N 3rd St, Folkston, GA 31537-1303 | 2005-06-01 |
| 1295174381 | Will Cameron Duncan | Physical Therapist | 1203 N 3rd St, Folkston, GA 31537-1303 | 2013-06-21 |
| 1841540622 | Stephanie Lisa Mcnulty | Physical Therapist | 1203 N 3rd St, Folkston, GA 31537-1303 | 2012-09-19 |
| 1700027364 | Robert Duaine Lott | Emergency Medicine | 1203 N 3rd St, Folkston, GA 31537-1303 | 2009-03-11 |
| 1932108594 | Jaimee Denyse Garcia | Physical Therapist | 1203 N 3rd St, Folkston, GA 31537-1303 | 2005-07-18 |
| Find all providers in zip 31537 | ||||
| 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 |
|---|---|---|---|---|
| 1548621089 | Mckinney Medical Center, Inc. | Clinic/Center | 3913 Main St, Folkston, GA 31537-7545 | 2016-03-11 |
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| 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 |
| Find all providers with the same taxonomy | ||||
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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.