HOSPITAL AUTHORITY OF LIBERTY COUNTY (NPI# 1063903011) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063903011 |
| Entity Type | Organization |
| Organization Name | HOSPITAL AUTHORITY OF LIBERTY COUNTY |
| Other Organization Name | LIBERTY REGIONAL MEDICAL CENTER-WALK-IN CLINIC |
| Practice Address |
462 Elma G Miles Pkwy Hinesville GA 31313-4000 |
| Practice Telephone | 9123699310 |
| Practice Fax Number | 9128773102 |
| Mailing Telephone | 9123699310 |
| Mailing Fax Number | 9128773102 |
| Enumeration Date | 2018-05-25 |
| Last Update Date | 2018-05-25 |
| Authorized Official Name | MICHAEL S HESTER (CEO) |
| Authorized Official Telephone | 9123699400 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261Q00000X | Clinic/Center | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Liberty Regional Medical Center-Walk-In Clinic | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508356395 | Hospital Authority of Liberty County | Obstetrics & Gynecology | 455 S Main St Ste 202, Hinesville, GA 31313-4354 | 2018-05-16 |
| 1023443801 | Hospital Authority of Liberty County | Clinic/Center | 128 Coastal Manor Dr Se, Ludowici, GA 31316-2951 | 2013-09-11 |
| 1013267202 | Hospital Authority of Liberty County | Pediatrics | 455 S.main Street Ste 105, Hinesville, GA 31313 | 2012-09-14 |
| 1356636534 | Hospital Authority of Liberty County | Family Medicine | 455 S.main Street Ste 104, Hinesville, GA 31313 | 2011-06-15 |
| 1477875839 | Hospital Authority of Liberty County | Internal Medicine | 455 S Main Street Suite 102, Hinesville, GA 31313 | 2010-02-25 |
| 1265463004 | Hospital Authority of Liberty County | Skilled Nursing Facility | Hwy 84 East, Ludowici, GA 31316 | 2006-07-06 |
| 1326079260 | Hospital Authority of Liberty County | General Acute Care Hospital | 462 E G Miles Parkway, Hinesville, GA 31313-4000 | 2006-07-06 |
| 1093214041 | Hospital Authority of Liberty County | General Practice | 586 Islands Highway, Midway, GA 31320 | 2018-02-06 |
| 1972028660 | Hospital Authority of Liberty County | General Practice | 73 Coastal Manor Dr, Ludowici, GA 31316 | 2017-08-03 |
| 1740516129 | Hospital Authority of Liberty County | Surgery | 455 S Main St Ste 105, Hinesville, GA 31313-4354 | 2009-10-20 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | HOSPITAL AUTHORITY OF LIBERTY COUNTY | 462 Elma G Miles Pkwy, Hinesville, GA 31313-4000 |
| Street Address |
462 ELMA G MILES PKWY |
| City | HINESVILLE |
| State | GA |
| Zip Code | 31313-4000 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013902741 | Nicole Stack Broerman | Pediatrics | 462 Elma G Miles Pkwy, Hinesville, GA 31313-4000 | 2005-09-19 |
| 1891260642 | Morgan Brown | Physical Therapist | 462 Elma G Miles Pkwy, Hinesville, GA 31313-4000 | 2018-10-08 |
| 1639619760 | Laura Christine Hayes | Nurse Practitioner | 462 Elma G Miles Pkwy, Hinesville, GA 31313-4000 | 2017-03-08 |
| 1952840449 | Patriot Anesthesia LLC | Anesthesiology | 462 Elma G Miles Pkwy, Hinesville, GA 31313-4000 | 2017-02-16 |
| 1316365729 | Nes of Florida, Inc. | Emergency Medicine | 462 Elma G Miles Pkwy, Hinesville, GA 31313-4000 | 2014-04-02 |
| 1063546737 | Nicole Petersen Shepard | Pediatrics | 462 Elma G Miles Pkwy, Hinesville, GA 31313-4000 | 2007-03-15 |
| 1508925488 | Amy Pearson, P.C. | Anesthesiology | 462 Elma G Miles Pkwy, Hinesville, GA 31313-4000 | 2006-12-07 |
| 1700842879 | Richard Robinson | Internal Medicine | 462 Elma G Miles Pkwy, Hinesville, GA 31313-4000 | 2006-04-26 |
| 1104888130 | Michele W Cahill | Nurse Anesthetist, Certified Registered | 462 Elma G Miles Pkwy, Hinesville, GA 31313-4000 | 2006-04-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447877469 | Brennan Roger Milbury | Naturopath | 4876 Ga 196 W, Hinesville, GA 31313 | 2020-06-26 |
| 1558982660 | Hinesville Day Spa LLC | Massage Therapist | 951 E G Miles Pkwy, Suite B, Hinesville, GA 31313 | 2020-04-29 |
| 1104459932 | Johnny Roger Terry | Counselor | 115 W Oglethorpe Hwy, Hinesville, GA 31313 | 2020-02-20 |
| 1043875594 | Liberty Regional Medical Center | Pharmacy | 462 Elma G. Miles Parkway, Hinesville, GA 31313 | 2019-05-09 |
| 1730646811 | Jennifer Lee Reffeor | Nurse Practitioner | 109 W Oglethorpe Highway, Hinesville, GA 31313 | 2019-02-26 |
| 1760907968 | Kenya Dominic | Specialist | 445 E.g. Miles Parkway Ste 207, Hinesville, GA 31313 | 2017-08-08 |
| 1902358393 | Tricia Amelung | Nurse Practitioner | 512 South Main St., Suite 1a, Hinesville, GA 31313 | 2016-11-01 |
| 1881065449 | Wal-mart Stores East Lp | Durable Medical Equipment & Medical Supplies | 801-a East General Stewart Way, Hinesville, GA 31313 | 2015-10-08 |
| 1245614916 | Tracey Bazemore | Counselor | 318 S. Wellborn Street, Suite C, Hinesville, GA 31313 | 2015-07-13 |
| 1831592021 | Jennifer Grisnik | Behavioral Analyst | 306 N. Main St., Suite 1a1, Hinesville, GA 31313 | 2014-10-01 |
| Find all providers in zip 31313 | ||||
| Taxonomy Code | 261Q00000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730353012 | William E. Wege, Dmd LLC | Clinic/Center | 110 Bagley Ave Ste B, Hinesville, GA 31313-3247 | 2008-04-17 |
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|---|---|---|---|---|
| 1619578820 | Pinpoint Covid Testing Inc | Clinic/Center | 3075 Tower Rd Ste A, Columbus, GA 31909-2537 | 2020-11-04 |
| 1194331439 | Shittu Family Practice,llc | Clinic/Center | 11679 Bruce Dr, Hampton, GA 30228-4008 | 2020-09-22 |
| 1154937050 | Staywellatl,llc | Clinic/Center | 2550 Heritage Ct Se Ste 135, Atlanta, GA 30339-3528 | 2020-09-17 |
| 1164035564 | The Lotus Haven PC | Clinic/Center | 950 Dannon Vw Sw Ste 4101, Atlanta, GA 30331-2159 | 2020-08-25 |
| 1518585868 | Robin June Dc, LLC | Clinic/Center | 400 Embassy Row Ste 110, Sandy Springs, GA 30328-5723 | 2020-07-13 |
| 1740808773 | All Test Services | Clinic/Center | 575 Sigman Rd Ne, Conyers, GA 30013-1311 | 2020-07-07 |
| 1134741580 | Knowles Exams & More | Clinic/Center | 123 Glyndale Dr Ste 107, Brunswick, GA 31520-1404 | 2020-05-08 |
| 1558981985 | Elite Mens' Health, LLC | Clinic/Center | 3361 Nottinghill Ln, Valdosta, GA 31605-5874 | 2020-04-27 |
| 1447886320 | Momentum Rehab & Therapy | Clinic/Center | 5349 Snapfinger Woods Dr, Decatur, GA 30035-4028 | 2020-03-23 |
| 1073146759 | Transitional Care Clinic LLC | Clinic/Center | 2084 Newnan Crossing Blvd E Ste 300, Newnan, GA 30265-2561 | 2020-02-20 |
| Find all providers with the same taxonomy | ||||
| City | HINESVILLE |
| Zip Code | 31313 |
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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.