SOUTHERN HEALTH CORP OF ELLIJAY (NPI# 1083144109) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083144109 |
| Entity Type | Organization |
| Organization Name | SOUTHERN HEALTH CORP OF ELLIJAY |
| Other Organization Name | PARKSIDE ELLIJAY |
| Practice Address |
1362 S Main St Ellijay GA 30540-5410 |
| Mailing Address |
Po Box 2239 Ellijay GA 30540-0025 |
| Practice Telephone | 7066357881 |
| Practice Fax Number | 7062763698 |
| Mailing Telephone | 7066357881 |
| Mailing Fax Number | 7062763698 |
| Enumeration Date | 2017-06-13 |
| Last Update Date | 2017-06-13 |
| Authorized Official Name | MS. SHEILA BROCKMAN (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Telephone | 7066357881 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR0401X |
Clinic/Center Specialization: Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Parkside Ellijay | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013248962 | Southern Health Corp of Ellijay | Clinic/Center | 60 Old Highway 5 South, Ellijay, GA 30540-5436 | 2010-01-15 |
| 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 |
| 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 |
1362 S MAIN ST |
| City | ELLIJAY |
| State | GA |
| Zip Code | 30540-5410 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 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 |
| 1861954620 | Parkside Operating Company LLC | Skilled Nursing Facility | 1362 S Main St, Ellijay, GA 30540-5410 | 2019-04-02 |
| 1194103788 | Nes of Florida Inc | Emergency Medicine | 1362 S Main St, Ellijay, GA 30540-5410 | 2015-05-14 |
| 1558753525 | Amanda Noe | Registered Nurse | 1362 S Main St, Ellijay, GA 30540-5410 | 2015-02-26 |
| 1851646467 | Stacey Lynne Evans-paulin | Physician Assistant | 1362 S Main St, Ellijay, GA 30540-5410 | 2012-07-19 |
| 1427329218 | Hospitalmd of Georgia Ip, Inc | Emergency Medicine | 1362 S Main St, Ellijay, GA 30540-5410 | 2012-01-25 |
| 1861762064 | Hospitalmd of Georgia, Inc. | Emergency Medicine | 1362 S Main St, Ellijay, GA 30540-5410 | 2012-01-04 |
| 1245473792 | S. Health Corporation of Ellijay | Durable Medical Equipment & Medical Supplies | 1362 S Main St, Ellijay, GA 30540-5410 | 2009-04-14 |
| 1073706073 | Comprehensive Hospitalist of Georgia LLC | Hospitalist | 1362 S Main St, Ellijay, GA 30540-5410 | 2007-08-22 |
| 1770774515 | Southern Health Corp of Ellijay | General Acute Care Hospital | 1362 S Main St, Ellijay, GA 30540-5410 | 2007-08-07 |
| Find all providers in the same location | ||||
| 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 | 261QR0401X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265046346 | Children's 1st Rehabilitation Center, Inc | Clinic/Center | 239 Village Center Pkwy Ste 190, Stockbridge, GA 30281-9024 | 2020-09-04 |
| 1124487749 | Pathway Outpatient Services, LLC | Clinic/Center | 241 Lemon St Ne, Marietta, GA 30060-1644 | 2016-02-11 |
| 1679915284 | Milestone Pediatric Therapy Services Inc. | Clinic/Center | 526 Jefferson Walk Cir, Jefferson, GA 30549-5573 | 2013-07-24 |
| 1013253376 | Southern Therapy Associates | Clinic/Center | 19350 Hartford St, Edison, GA 39846-5617 | 2012-12-13 |
| 1851578074 | Champion Fit Wellness | Clinic/Center | 3617 Salem Rd, Covington, GA 30016-4552 | 2008-01-30 |
| 1013472026 | Parrott Solutions, LLC | Clinic/Center | 6670 James B Rivers Memorial Drive, Stone Mountain, GA 30083 | 2019-02-04 |
| 1700129798 | Martha Sam | Clinic/Center | 1203 Cleveland Ave, Suite 1 A, East Point, GA 30344-3417 | 2013-03-28 |
| 1568705572 | Fleming Medical Center Inc | Clinic/Center | 1203 Cleveland Ave, 1 A, East Point, GA 30344-3417 | 2013-03-28 |
| 1629326178 | Johns Creek Therapy Center, LLC | Clinic/Center | 4255 Johns Creek Pkwy, Suite A, Suwanee, GA 30024-6122 | 2012-08-15 |
| 1275852949 | Hyox Medical Treatment Center | Clinic/Center | 500 Medical Center Blvd, Suite 170, Lawrenceville, GA 30046-8708 | 2010-05-20 |
| 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.