FAMILY PRACTICE OF HABERSHAM PC (NPI# 1124154794) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124154794 |
| Entity Type | Organization |
| Organization Name | FAMILY PRACTICE OF HABERSHAM PC |
| Other Organization Name | HABERSHAM PRIMARY CARE |
| Practice Address |
590 Historic Hwy 441 N Demorest GA 30535-1779 |
| Mailing Address |
Po Box 1779 Demorest GA 30535-1779 |
| Practice Telephone | 7067545511 |
| Practice Fax Number | 7067545577 |
| Mailing Telephone | 7067545511 |
| Mailing Fax Number | 7067545577 |
| Enumeration Date | 2007-02-26 |
| Last Update Date | 2008-12-16 |
| Authorized Official Name | MS. BEVERLY C CARTER (MANAGER) |
| Authorized Official Telephone | 7067541252 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2300X |
Clinic/Center Specialization: Primary Care |
032741 | GA | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | MEDICARE GRP # | GRP3078 | 01 |
| Other Name | Type Code |
|---|---|
| Habersham Primary Care | Former Legal Business Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093717357 | Family Practice of Habersham PC | Internal Medicine | 590 Historic Hwy 441 N, Demorest, GA 30535 | 2005-06-01 |
| Street Address |
590 HISTORIC HWY 441 N |
| City | DEMOREST |
| State | GA |
| Zip Code | 30535-1779 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093717357 | Family Practice of Habersham PC | Internal Medicine | 590 Historic Hwy 441 N, Demorest, GA 30535 | 2005-06-01 |
| 1255581138 | The Hospital Authority of Habersham County | Orthopaedic Surgery | 590 Historic Hwy 441 N, Demorest, GA 30535 | 2008-09-26 |
| 1427248731 | Tabatha P Anderson | Nurse Practitioner | 590 Historic Hwy 441 N, Demorest, GA 30535 | 2007-08-01 |
| 1679503833 | James E Spoden | Otolaryngology | 590 Historic Hwy 441 N, Suite D, Demorest, GA 30535 | 2006-07-04 |
| 1609878974 | John Timothy Cope | Internal Medicine | 590 Historic Hwy 441 N, Demorest, GA 30535 | 2005-06-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396353355 | Kristen Diana Maxwell X | Nurse Practitioner | 396 Historic Highway 441 North, Demorest, GA 30535 | 2020-07-16 |
| 1659925972 | Jared Davis | Physical Therapist | 541 Historic Hiwy 441, Demorest, GA 30535 | 2019-07-25 |
| 1669939070 | Habersham Medical Center Foundation, Inc. | Pharmacy | 541 Old Historic Hwy 441 N Ste 1, Demorest, GA 30535 | 2019-02-22 |
| 1114417128 | The Hospital Authority of Habersham County | Family Medicine | 638 Hwy 441 N Suite B-2, Demorest, GA 30535 | 2018-05-15 |
| 1578077434 | Linh My Dao | Registered Nurse | 541 Historic Hwy. 441-n, Demorest, GA 30535 | 2017-11-29 |
| 1447797063 | Cmvo, LLC | Pharmacy | 4654 Highway 115, Unit 1, Demorest, GA 30535 | 2017-01-20 |
| 1851741128 | Katherine Glenn | Physical Therapy Assistant | 541 Us-441 Bus, Demorest, GA 30535 | 2016-06-17 |
| 1558735886 | Waterfall Emergency Physicians, LLC | Physician Assistant | 541 Historic Hwy 441n, Demorest, GA 30535 | 2015-11-24 |
| 1407278237 | Deborah Gale | Pharmacist | 116 Savannah Ter, Demorest, GA 30535 | 2014-01-14 |
| 1538580576 | Garrett Family Medicine, LLC | Family Medicine | 590 Historic Hwy 441 Lower Level, Demorest, GA 30535 | 2013-12-18 |
| Find all providers in zip 30535 | ||||
| Taxonomy Code | 261QP2300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Primary Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740778828 | The Hospital Authority of Habersham County | Clinic/Center | 638 Historic Hwy 441 N, Suite B-1, Demorest, GA 30535 | 2018-04-25 |
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| 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.