PHOEBE SUMTER MEDICAL CENTER, INC (NPI# 1376778001) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376778001 |
| Entity Type | Organization |
| Organization Name | PHOEBE SUMTER MEDICAL CENTER, INC |
| Other Organization Name | PHOEBE SUMTER ELLAVILLE CLINIC |
| Practice Address |
339 S Broad St Ellaville GA 31806-3304 |
| Mailing Address |
Po Box 65 Ellaville GA 31806-9228 |
| Practice Telephone | 2299375321 |
| Practice Fax Number | 2299372232 |
| Mailing Telephone | 2299375321 |
| Mailing Fax Number | 2299342232 |
| Enumeration Date | 2009-05-26 |
| Last Update Date | 2018-02-14 |
| Authorized Official Name | BRANDI LUNNEBORG (CEO) |
| Authorized Official Telephone | 2299311191 |
| Is Organization Subpart | Y |
| Parent Organization Name | PHOEBE SUMTER MEDICAL CENTER, INC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR1300X |
Clinic/Center Specialization: Rural Health |
GA | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 003112355A | 05 |
| Other Name | Type Code |
|---|---|
| Phoebe Sumter Ellaville Clinic | Doing Business As Name - Organization |
| Street Address |
339 S BROAD ST |
| City | ELLAVILLE |
| State | GA |
| Zip Code | 31806-3304 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568017663 | Angelita Reyes Quiroz | Nurse Practitioner | 339 S Broad St, Ellaville, GA 31806-3304 | 2019-08-06 |
| 1447705173 | Elizabeth Kate Albritton | Nurse Practitioner | 339 S Broad St, Ellaville, GA 31806 | 2016-08-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073054946 | Compass Family Healthcare LLC | Nurse Practitioner | 22 West Oglethorpe Street, Ellaville, GA 31806 | 2017-03-13 |
| 1114338761 | Juliane Cody Johnson | Nurse Practitioner | 41 East Oglethorpe Street, Ellaville, GA 31806 | 2014-05-16 |
| 1679615413 | Sandra D Daniel | Nurse Practitioner | 72 South Broad, Ellaville, GA 31806 | 2007-02-12 |
| 1689734253 | Gill Drug Co. Inc. | Pharmacy | 54 East Oglethorpe Street, Ellaville, GA 31806 | 2006-12-12 |
| 1114092129 | Rebecca Faye Williams | Pharmacist | 560 S. Broad St, Ellaville, GA 31806 | 2006-11-22 |
| 1477647824 | Sumter Regional Hospital | Clinic/Center | 72 S Broad St, Ellaville, GA 31806 | 2006-10-02 |
| 1205932381 | Schley County Commissioner | Ambulance | 106 North Pecan Street, Ellaville, GA 31806 | 2006-09-15 |
| 1558398503 | Schley County Board of Health | Public Health or Welfare | 45 W. Oglethorpe St, Suite B, Ellaville, GA 31806 | 2006-06-26 |
| 1487036075 | Careconnect Health, Inc. | Clinic/Center | 41 East Oglethorpe Street, Ellaville, GA 31806 | 2015-06-19 |
| 1487719076 | Sumter Regional Hospital | Clinic/Center | 72 S. Broad St., Ellaville, GA 31806 | 2006-12-26 |
| Find all providers in zip 31806 | ||||
| Taxonomy Code | 261QR1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rural Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477647824 | Sumter Regional Hospital | Clinic/Center | 72 S Broad St, Ellaville, GA 31806 | 2006-10-02 |
| 1487719076 | Sumter Regional Hospital | Clinic/Center | 72 S. Broad St., Ellaville, GA 31806 | 2006-12-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437651924 | Amanda Mckenzie | Clinic/Center | Us Renal Care 657 Hemlock Street, Macon, GA 31206 | 2018-03-01 |
| 1518398049 | Norman Park Family Medicine Clinic | Clinic/Center | 139 East Broad Street, Norman Park, GA 31771 | 2013-12-10 |
| 1992147573 | Doerun Family Medicine Clinic | Clinic/Center | 128 West Broad Ave, Doerun, GA 31744 | 2013-07-23 |
| 1366784415 | Emanuel County Hospital Authority | Clinic/Center | 131a Victory Dr, Swainsboro, GA 30401-3234 | 2013-03-26 |
| 1306114004 | Lower Oconee Community Hospital, Inc | Clinic/Center | 421 W Robinson Dr, Mount Vernon, GA 30445-2935 | 2011-12-08 |
| 1013248962 | Southern Health Corp of Ellijay | Clinic/Center | 60 Old Highway 5 South, Ellijay, GA 30540-5436 | 2010-01-15 |
| 1427384353 | Union County Hospital Authority | Clinic/Center | 103 Church St Ste A, Hiawassee, GA 30546-3223 | 2009-10-28 |
| 1346574084 | Durall Capital Holdings, LLC | Clinic/Center | 59 Tipton Drive, Dahlonega, GA 30533 | 2009-09-29 |
| 1215260617 | Durall Capital Holdings, LLC | Clinic/Center | 35 Lumpkin Campground Road N, Dawsonville, GA 30534 | 2009-09-16 |
| 1720227895 | The Baxley and Appling County Hospital Authority | Clinic/Center | 105 E Tollison St, Suite D, Baxley, GA 31513-0149 | 2009-02-13 |
| 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.