SOUTHERN HEALTH CORP OF ELLIJAY (NPI# 1013248962) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013248962 |
| Entity Type | Organization |
| Organization Name | SOUTHERN HEALTH CORP OF ELLIJAY |
| Other Organization Name | NORTH GEORGIA FAMILY PRACTICE |
| Practice Address |
60 Old Highway 5 South Ellijay GA 30540-5436 |
| Mailing Address |
Po Box 1019 Ellijay GA 30540-0013 |
| Practice Telephone | 7062764741 |
| Practice Fax Number | 7062764645 |
| Mailing Telephone | 7062764741 |
| Mailing Fax Number | 7062764645 |
| Enumeration Date | 2010-01-15 |
| Last Update Date | 2015-01-28 |
| Authorized Official Name | MS. DEBBIE ANN SELF (CFO) |
| Authorized Official Telephone | 7062764741 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR1300X |
Clinic/Center Specialization: Rural Health |
061435 | GA | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | RURAL HEALTH CLINIC | 118527 | 01 |
| Other Name | Type Code |
|---|---|
| North Georgia Family Practice | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962683961 | Southern Health Corp of Ellijay | Family Medicine | 61 Highland Ct, Suite 101, East Ellijay, GA 30540-6777 | 2007-11-19 |
| 1952395097 | Southern Health Corp of Ellijay | General Acute Care Hospital | 1362 S Main St, 822 Industrial Blvd; 60 Old Highway 5 South, Ellijay, GA 30540-5410 | 2005-09-05 |
| 1083144109 | Southern Health Corp of Ellijay | Clinic/Center | 1362 S Main St, Ellijay, GA 30540-5410 | 2017-06-13 |
| 1619284445 | Southern Health Corp of Ellijay | General Acute Care Hospital | 772 Maddox Dr, Suite 112, East Ellijay, GA 30540-8194 | 2010-08-31 |
| 1790932655 | Southern Health Corp of Ellijay | Internal Medicine | 190 Hospital Cir, Ellijay, GA 30540-9694 | 2008-08-22 |
| 1770774515 | Southern Health Corp of Ellijay | General Acute Care Hospital | 1362 S Main St, Ellijay, GA 30540-5410 | 2007-08-07 |
| 1407062862 | Southern Health Corp of Ellijay | Clinic/Center | 822 Industrial Blvd, Ellijay, GA 30540-3804 | 2007-05-15 |
| 1275690703 | Southern Health Corp of Ellijay | Medicare Defined Swing Bed Unit | 1362 S Main St, Ellijay, GA 30540-5410 | 2007-01-03 |
| 1902963580 | Southern Health Corp of Ellijay | Nursing Facility/Intermediate Care Facility | 1362 S Main St, Ellijay, GA 30540-5410 | 2007-01-02 |
| Street Address |
60 OLD HIGHWAY 5 SOUTH |
| City | ELLIJAY |
| State | GA |
| Zip Code | 30540-5436 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760929517 | Sandi Lynn Harris | Pharmacist | 192 1st St, East Ellijay, GA 30540 | 2017-01-31 |
| 1194028688 | Heartlite Hospice Ellijay, Inc. | Hospice Care, Community Based | 163 Dalton Street, East Ellijay, GA 30540 | 2010-12-06 |
| 1972816874 | Nicole Penland Bond | Nurse Practitioner | 174 Highland Crossing East, East Ellijay, GA 30540 | 2010-07-20 |
| 1689994477 | Immediate Medcare, LLC | Clinic/Center | 174 Highland Crossing South, East Ellijay, GA 30540 | 2010-06-03 |
| 1316274830 | Huffs Select Care Clinic PC | Clinic/Center | 136-a Industrial Blvd, Ellijay, GA 30540 | 2009-11-04 |
| 1598924615 | Hospice Advantage, LLC. | Hospice Care, Community Based | 583 Highland Xing, Suite 120, East Ellijay, GA 30540 | 2008-06-04 |
| 1083891196 | Roy Elie Abrahamian | Internal Medicine | 309 Highland Pkwy Ste 200, East Ellijay, GA 30540 | 2008-01-31 |
| 1285817213 | Quality Respi-care Inc | Durable Medical Equipment & Medical Supplies | 97 Hefner St Ste 102, East Ellijay, GA 30540 | 2007-12-13 |
| 1275738163 | Jennifer Moss Houle | Technician, Other | 7 Depot Street, Ellijay, GA 30540 | 2007-06-19 |
| 1265633697 | Alicia S Lovelace | Specialist | 630 Blazing Star Rd, Ellijay, GA 30540 | 2007-05-31 |
| Find all providers in zip 30540 | ||||
| Taxonomy Code | 261QR1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rural Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407062862 | Southern Health Corp of Ellijay | Clinic/Center | 822 Industrial Blvd, Ellijay, GA 30540-3804 | 2007-05-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437651924 | Amanda Mckenzie | Clinic/Center | Us Renal Care 657 Hemlock Street, Macon, GA 31206 | 2018-03-01 |
| 1518398049 | Norman Park Family Medicine Clinic | Clinic/Center | 139 East Broad Street, Norman Park, GA 31771 | 2013-12-10 |
| 1992147573 | Doerun Family Medicine Clinic | Clinic/Center | 128 West Broad Ave, Doerun, GA 31744 | 2013-07-23 |
| 1366784415 | Emanuel County Hospital Authority | Clinic/Center | 131a Victory Dr, Swainsboro, GA 30401-3234 | 2013-03-26 |
| 1306114004 | Lower Oconee Community Hospital, Inc | Clinic/Center | 421 W Robinson Dr, Mount Vernon, GA 30445-2935 | 2011-12-08 |
| 1427384353 | Union County Hospital Authority | Clinic/Center | 103 Church St Ste A, Hiawassee, GA 30546-3223 | 2009-10-28 |
| 1346574084 | Durall Capital Holdings, LLC | Clinic/Center | 59 Tipton Drive, Dahlonega, GA 30533 | 2009-09-29 |
| 1215260617 | Durall Capital Holdings, LLC | Clinic/Center | 35 Lumpkin Campground Road N, Dawsonville, GA 30534 | 2009-09-16 |
| 1376778001 | Phoebe Sumter Medical Center, Inc | Clinic/Center | 339 S Broad St, Ellaville, GA 31806-3304 | 2009-05-26 |
| 1720227895 | The Baxley and Appling County Hospital Authority | Clinic/Center | 105 E Tollison St, Suite D, Baxley, GA 31513-0149 | 2009-02-13 |
| 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.