FANNIN REGIONAL HOSPITAL INC (NPI# 1144298548) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1144298548 |
| Entity Type | Organization |
| Organization Name | FANNIN REGIONAL HOSPITAL INC |
| Other Organization Name | TRI COUNTY DIAGNOSTIC CENTER |
| Practice Address |
772 Maddox Dr Ste 126 East Ellijay GA 30540-8194 |
| Mailing Address |
Po Box 198161 Atlanta GA 30384-8161 |
| Practice Telephone | 7062732105 |
| Enumeration Date | 2006-03-10 |
| Last Update Date | 2008-08-20 |
| Authorized Official Name | LAURIE HOLTSFORD (SENIOR VP, GROUP OPERATIONS) |
| Authorized Official Telephone | 6154657466 |
| Is Organization Subpart | Y |
| Parent Organization Name | FANNIN REGIONAL HOSPITAL INC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QM1200X |
Clinic/Center Specialization: Magnetic Resonance Imaging (MRI) |
GA | Ambulatory Health Care Facilities | |
| Y | 261QR0200X |
Clinic/Center Specialization: Radiology |
055-452 | GA | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Tri County Diagnostic Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467583724 | Fannin Regional Hospital Inc | Radiology | 2855 Old Highway 5, Blue Ridge, GA 30513-6248 | 2007-03-08 |
| Street Address |
772 MADDOX DR STE 126 |
| City | EAST ELLIJAY |
| State | GA |
| Zip Code | 30540-8194 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366446338 | Bonnie G Bradley | Optometrist | 772 Maddox Dr, Suite 132, East Ellijay, GA 30540-8194 | 2005-06-08 |
| 1619284445 | Southern Health Corp of Ellijay | General Acute Care Hospital | 772 Maddox Dr, Suite 112, East Ellijay, GA 30540-8194 | 2010-08-31 |
| 1851619506 | Bradley Eye Associates, Inc | Optometrist | 772 Maddox Dr, Suite 132, East Ellijay, GA 30540-8194 | 2010-05-05 |
| 1609087527 | David Romesh Persaud | Family Medicine | 772 Maddox Dr, Ste. 122, East Ellijay, GA 30540-8196 | 2007-05-24 |
| 1942353644 | Suzanne Young | Nurse Practitioner | 772 Maddox Dr, Suite 122, East Ellijay, GA 30540-8196 | 2007-01-18 |
| 1144314998 | Professional Eye Associate | Eyewear Supplier (Equipment, not the service) | 772 Maddox Dr, Suite 132, East Ellijay, GA 30540-8194 | 2006-10-03 |
| 1336127174 | Apple Medical Center | Clinic/Center | 772 Maddox Dr, Suite 110, East Ellijay, GA 30540-8194 | 2006-01-03 |
| 1043203599 | Daniela Maria Rojas-molina | Family Medicine | 772 Maddox Dr, Suite 122, East Ellijay, GA 30540-8196 | 2005-08-30 |
| 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 | 261QR0200X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Radiology |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770101701 | Clear Imaging LLC | Clinic/Center | 5730 Glenridge Dr Ste T300, Sandy Springs, GA 30328-5871 | 2020-07-07 |
| 1881218964 | American Health Imaging of Georgia LLC | Clinic/Center | 30 Janet Dr, Savannah, GA 31405-5518 | 2020-06-03 |
| 1952948291 | Catching Point Physician Centers, LLC | Clinic/Center | 3333 Old Milton Pkwy Ste G100, Alpharetta, GA 30005-0008 | 2019-12-05 |
| 1447802780 | American Health Imaging of Ga LLC | Clinic/Center | 2851 Washington Rd, Augusta, GA 30909-2131 | 2019-07-16 |
| 1700445582 | American Health Imaging of Ga LLC | Clinic/Center | 4374 Atlanta Hwy Ste 125, Hiram, GA 30141-1852 | 2019-06-06 |
| 1508425380 | American Health Imaging of Ga LLC | Clinic/Center | 796 Church St Ne Ste 100, Marietta, GA 30060-7228 | 2019-06-06 |
| 1588229918 | Synergy Radiology, LLC | Clinic/Center | 6025 Professional Pkwy Ste 104, Douglasville, GA 30134-5610 | 2019-05-01 |
| 1134645351 | M & B Imaging, PC | Clinic/Center | 2485 Jefferson Rd, Athens, GA 30607-1202 | 2017-08-18 |
| 1548785330 | American Health Imaging of Georgia LLC | Clinic/Center | 1103 Fountain Lake Dr, Brunswick, GA 31525-3039 | 2017-08-14 |
| 1164966461 | Pro Radiology, LLC | Clinic/Center | 60 Peachtree Park Dr Ne, Atlanta, GA 30309-1304 | 2016-12-06 |
| Find all providers with the same taxonomy | ||||
| City | EAST ELLIJAY |
| Zip Code | 30540 |
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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.