SOUTH GEORGIA TREATMENT, INC (NPI# 1093963944) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093963944 |
| Entity Type | Organization |
| Organization Name | SOUTH GEORGIA TREATMENT, INC |
| Practice Address |
794 Mcdonough Rd Jackson GA 30233-1572 |
| Practice Telephone | 7707759044 |
| Mailing Telephone | 7707759044 |
| Enumeration Date | 2008-09-04 |
| Last Update Date | 2008-09-04 |
| Authorized Official Name | MS. NICOLE RAE MCCONNELL (ADMINISTRATOR) |
| Authorized Official Telephone | 7707759044 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM2800X |
Clinic/Center Specialization: Methadone Clinic |
NTP-001027 | GA | Ambulatory Health Care Facilities |
| Street Address |
794 MCDONOUGH RD |
| City | JACKSON |
| State | GA |
| Zip Code | 30233-1572 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558330522 | Renal Treatment Centers Mid Atlantic Inc | Clinic/Center | 794 Mcdonough Rd, Jackson, GA 30233-1572 | 2006-03-14 |
| 1740755719 | Byron A Thompson | Counselor | 794 Mcdonough Rd, Jackson, GA 30233 | 2018-10-05 |
| 1750789947 | Select Interventional Pain, PC | Pain Medicine | 794 Mcdonough Rd, Suite 108, Jackson, GA 30233-1572 | 2014-12-20 |
| 1306126529 | Jaimi Marie Norrell | Nurse Practitioner | 794 Mcdonough Rd, 111, Jackson, GA 30233-1572 | 2011-08-18 |
| 1992943195 | Dana B Bass Burch | Physician Assistant | 794 Mcdonough Rd, Suite 111, Jackson, GA 30233-1572 | 2009-01-26 |
| 1306019104 | Bennie R White Jr Md Inc | Clinic/Center | 794 Mcdonough Rd, Suite 105, Jackson, GA 30233-1572 | 2008-04-12 |
| 1306025630 | Derrell Levohn Leggett | Anesthesiology | 794 Mcdonough Rd, Suite 108, Jackson, GA 30233-1572 | 2007-11-02 |
| 1033329198 | Jackson Dialysis Center | Clinic/Center | 794 Mcdonough Rd, Suite 108, Jackson, GA 30233-1572 | 2007-05-23 |
| 1376575225 | Bennie R. White Jr. | Family Medicine | 794 Mcdonough Rd, Suite 105, Jackson, GA 30233-1572 | 2006-07-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366800914 | Georgia Ophthalmologists LLC | Durable Medical Equipment & Medical Supplies | 860 W 3rd St, Jackson, GA 30233 | 2016-02-10 |
| 1306225057 | Young Dreaden | Nurse Practitioner | 2978 Hwy 36w, Jackson, GA 30233 | 2015-05-28 |
| 1609255520 | Neta J Roby | Nurse Practitioner | Hwy 36, Georgia Diagnostic Classification Prison, Jackson, GA 30233 | 2015-05-26 |
| 1033546098 | Henrietta Lindsay | Social Worker | 463-b Ernest Biles Dr, Jackson, GA 30233 | 2013-10-04 |
| 1255776993 | Gareth Gene Walker | Technician | 514 Covinton Street, Jackson, GA 30233 | 2013-05-08 |
| 1730489592 | Mary L. Melton | Licensed Practical Nurse | 463 Ernest Biles Dr., Jackson, GA 30233 | 2010-10-27 |
| 1083864250 | Chastity Moore Brown | Dentist | 1520 Lucky Street, Griffin, GA 30233 | 2008-09-24 |
| 1568661320 | Joseph Fowlkes | Internal Medicine | 2978 Highway 36 W, Jackson, GA 30233 | 2007-07-12 |
| 1942386289 | Butts County Board of Commissioners | Ambulance | 154 Sylvan Drive, Jackson, GA 30233 | 2006-10-30 |
| 1841238300 | Jackson Pharmacy Services | Pharmacy | 22 Mulberry St., Jackson, GA 30233 | 2006-06-04 |
| Find all providers in zip 30233 | ||||
| Taxonomy Code | 261QM2800X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Methadone Clinic |
| An entity, facility, or distinct part of a facility providing diagnostic, and replacement maintenance treatment services related to individuals with drug addiction. |
| Notes: [7/1/2003: new] |
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|---|---|---|---|---|
| 1629510540 | Mississippi Comprehensive Treatment Centers, LLC | Clinic/Center | 1935 Lakeland Dr Ste 900, Jackson, MS 39216-5028 | 2016-11-09 |
| 1871752105 | Raleigh Professional Associates | Clinic/Center | 1869 Highway 45 Byp, Suite 5, Jackson, TN 38305-2464 | 2008-06-02 |
| 1164878419 | Ann Marshall | Clinic/Center | 2964 Terry Rd, Jackson, MS 39212-3055 | 2016-05-05 |
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| 1275165755 | Walton County Treatment Center LLC | Clinic/Center | 3543 Highway 81 Ste 201, Loganville, GA 30052-4336 | 2020-02-12 |
| 1023640596 | Georgia Treatment Center LLC | Clinic/Center | 514 W Maple St Ste 1206, Cumming, GA 30040-2536 | 2020-02-12 |
| 1417587502 | Ringgold Treatment Center LLC | Clinic/Center | 8292 Highway 41, Ringgold, GA 30736-2354 | 2020-01-17 |
| 1952931164 | Southeast Georgia Treatment Center | Clinic/Center | 816 Professional Center Dr, Eastman, GA 31023-6734 | 2020-01-16 |
| 1508405150 | Woodstock Treatment Center LLC | Clinic/Center | 270 Heritage Walk, Woodstock, GA 30188-3875 | 2019-12-30 |
| 1588208128 | Narquest Healthcare Services, LLC | Clinic/Center | 1766 Memorial Dr Ste 3, Waycross, GA 31501-1098 | 2019-11-06 |
| 1619511334 | Douglasville Healthcare Services, LLC | Clinic/Center | 4158 Washington Rd Ste 4, Evans, GA 30809-4720 | 2019-11-06 |
| 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.