HOSPITAL AUTHORITY OF LIBERTY COUNTY (NPI# 1356636534) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356636534 |
| Entity Type | Organization |
| Organization Name | HOSPITAL AUTHORITY OF LIBERTY COUNTY |
| Other Organization Name | LIBERTY FAMILY MEDICINE |
| Practice Address |
455 S.main Street Ste 104 Hinesville GA 31313 |
| Mailing Address |
455 S Main Street Suite 104 Hinesville GA 31313-4354 |
| Practice Telephone | 9128765644 |
| Practice Fax Number | 9124083457 |
| Mailing Telephone | 9128765644 |
| Mailing Fax Number | 9128776341 |
| Enumeration Date | 2011-06-15 |
| Last Update Date | 2016-07-28 |
| Authorized Official Name | MR. MICHAEL S HESTER (CEO) |
| Authorized Official Telephone | 9123699400 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 065972 | GA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | STATE LICENSE | 065972 | 01 |
| Other Name | Type Code |
|---|---|
| LIBERTY FAMILY MEDICINE | 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 |
| 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 |
| 1063903011 | Hospital Authority of Liberty County | Clinic/Center | 462 Elma G Miles Pkwy, Hinesville, GA 31313-4000 | 2018-05-25 |
| 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 |
455 S.MAIN STREET STE 104 |
| City | HINESVILLE |
| State | GA |
| Zip Code | 31313 |
| 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 | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083843296 | Vincent Jones | Family Medicine | 103 E General Stewart Way, B, Hinesville, GA 31313-2607 | 2009-07-09 |
| 1578785523 | Grace C. Bautista | Family Medicine | 103 West General Screven Way, Suite E, Hinesville, GA 31313 | 2007-05-02 |
| 1053571117 | Atul M. Devani | Family Medicine | 462 Elma G Miles Pkwy Ste 102a, Hinesville, GA 31313 | 2008-06-12 |
| 1972763043 | Ophelia P Gherman | Family Medicine | 455 S Main St, Suite 104, Hinesville, GA 31313-4353 | 2008-06-12 |
| 1164559571 | Noemi Adelina Carcar | Family Medicine | 303 Fraser Dr, Hinesville, GA 31313-3712 | 2007-02-27 |
| 1710048228 | Carlos A Medina | Family Medicine | 500 E Oglethorpe Hwy, Hinesville, GA 31313-2804 | 2006-12-12 |
| 1447344478 | Contemporary Medicine, LLC | Family Medicine | 455 S Main St, Suite 103, Hinesville, GA 31313-4353 | 2006-10-03 |
| 1063440774 | David M. Nussbaum | Family Medicine | 303 Fraser Dr, Hinesville, GA 31313 | 2006-06-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124629365 | Dima Healthcare, Inc | Family Medicine | 7768 Cumming Hwy Ste 300, Canton, GA 30115-2982 | 2020-11-04 |
| 1871192260 | Ashley Willingham | Family Medicine | 210 Carlisle Way, Savannah, GA 31419-6606 | 2020-10-18 |
| 1831706217 | Veronica Vante | Family Medicine | 200 Business Center Dr Ste 204, Stockbridge, GA 30281-9025 | 2020-09-29 |
| 1912514969 | Oasis Healthcare Service | Family Medicine | 2195 Pace St Ste E, Covington, GA 30014-6657 | 2020-09-24 |
| 1881200772 | My Nurse Now, LLC | Family Medicine | 7070 Hodgson Memorial Dr, Savannah, GA 31406-2529 | 2020-09-16 |
| 1598377319 | Renee Green Lewis | Family Medicine | 9 Bluelake Blvd, Pooler, GA 31322-9617 | 2020-08-21 |
| 1841800836 | Ascend Medical Georgia PC | Family Medicine | One Alliance Center, 3500 Lenox Road Suite 1500, Atlanta, GA 30326 | 2020-08-04 |
| 1407464084 | Railyard Family Medicine LLC | Family Medicine | 416 Grayson Pkwy, Grayson, GA 30017-1220 | 2020-07-20 |
| 1851909535 | Newly Sought After International LLC | Family Medicine | 11815 Northfall Ln Ste 1001, Alpharetta, GA 30009-7973 | 2020-07-17 |
| 1992323398 | Careperks LLC | Family Medicine | 4936 Presidents Way, Tucker, GA 30084-3038 | 2020-07-12 |
| 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.