PRIMARY HEALTH CARE CENTER OF DADE, INC. (NPI# 1437102449) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1437102449 |
| Entity Type | Organization |
| Organization Name | PRIMARY HEALTH CARE CENTER OF DADE, INC. |
| Practice Address |
13570 N Main St Trenton GA 30752-2012 |
| Practice Telephone | 7069562665 |
| Practice Fax Number | 7066575885 |
| Mailing Telephone | 7066577575 |
| Mailing Fax Number | 7066576575 |
| Enumeration Date | 2006-05-19 |
| Last Update Date | 2019-01-21 |
| Authorized Official Name | LINDA S NIXON (CHIEF FINANCIAL OFFICER) |
| Authorized Official Telephone | 7066577575 |
| Authorized Official Credential | CFO |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 1223G0001X |
Dentist Specialization: General Practice |
Dental Providers | ||
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 000211956A | 05 | |
| GA | WELLCARE (GA MEDICAID MCO | 336412 | 01 |
| GA | AMERIGROUP (GA MEDICAID) | 10057286 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891395620 | Primary Health Care Center of Dade, Inc. | Clinic/Center | 8a Probasco Street Unit 214, Lafayette, GA 30728 | 2020-10-30 |
| 1699016527 | Primary Health Care Center of Dade, Inc. | Clinic/Center | 134 Rhea Mcclanahan Dr, Tunnel Hill, GA 30755-7328 | 2013-03-01 |
| 1356715452 | Primary Health Care Center of Dade, Inc. | Clinic/Center | 87 S Burnt Mill Rd, La Fayette, GA 30728-4263 | 2015-11-30 |
| 1235505678 | Primary Health Care Center of Dade, Inc. | Clinic/Center | 87 S Burnt Mill Rd, La Fayette, GA 30728-4263 | 2015-08-20 |
| 1457770612 | Primary Health Care Center of Dade, Inc. | Clinic/Center | 11638 Highway 27, Suite 8, Summerville, GA 30747-8514 | 2014-04-15 |
| 1952723298 | Primary Health Care Center of Dade, Inc. | Clinic/Center | 118 E Girard Ave, Cedartown, GA 30125-2778 | 2014-01-06 |
| 1255512182 | Primary Health Care Center of Dade, Inc. | Clinic/Center | 205 Jenkins Rd, Rossville, GA 30741 | 2007-11-20 |
| Street Address |
13570 N MAIN ST |
| City | TRENTON |
| State | GA |
| Zip Code | 30752-2012 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780649012 | Lucinda S Hill | Family Medicine | 13570 N Main St, Trenton, GA 30752-2012 | 2006-04-19 |
| 1780208835 | Shalane Marie Lamb | Nurse Practitioner | 13570 N Main St, Trenton, GA 30752-2012 | 2020-06-04 |
| 1518593151 | Felix D Cruz | Counselor | 13570 N Main St, Trenton, GA 30752-2012 | 2020-03-16 |
| 1871152587 | Anna Katharine Horne | Counselor | 13570 N Main St, Trenton, GA 30752-2012 | 2019-06-07 |
| 1962997189 | Katharine Renee Scott | Dietitian, Registered | 13570 N Main St, Trenton, GA 30752-2012 | 2018-06-29 |
| 1750829040 | Amy Nicole Scott | Nurse Practitioner | 13570 N Main St, Trenton, GA 30752-2012 | 2017-02-07 |
| 1407210107 | Danielle C Townsend | Dietitian, Registered | 13570 N Main St, Trenton, GA 30752-2012 | 2016-04-08 |
| 1306209788 | Anna E Thomas | Dietitian, Registered | 13570 N Main St, Trenton, GA 30752-2012 | 2016-04-01 |
| 1093189540 | Jenny Scott | Nurse Practitioner | 13570 N Main St, Trenton, GA 30752-2012 | 2015-11-20 |
| 1245600725 | Sheena Anderson-finch | Nurse Practitioner | 13570 N Main St, Trenton, GA 30752-2012 | 2015-09-28 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770126492 | Frederic Oehlschlaeger | Pharmacist | 5431 Ga-136, Trenton, GA 30752 | 2019-10-25 |
| 1649700212 | Lisa Michelle Stephans | Counselor | 12586 North Main Street, Trenton, GA 30752 | 2017-06-15 |
| 1881019305 | Crystal L Hancock | Nurse Practitioner | 12978 North Main Street, Trenton, GA 30752 | 2014-02-20 |
| 1548602758 | Freds Stores of Tennessee Inc. | Pharmacy | 11858 S Main St, Trenton, GA 30752 | 2013-07-29 |
| 1699021360 | Megan Hall Nunn | Pharmacist | 112 Crimson Drive, Trenton, GA 30752 | 2012-07-31 |
| 1881886398 | Complete Chiropractic Care, LLC | Chiropractor | 12551 North Main, Trenton, GA 30752 | 2007-08-17 |
| 1184783771 | Cindy Marie Simmons | Physician Assistant | 111 North Pine Street, Trenton, GA 30752 | 2006-12-08 |
| 1124190962 | Lookout Mountain Community Services | Community/Behavioral Health | 12580 North Main St., Trenton, GA 30752 | 2006-11-15 |
| 1386725893 | Dade County Board of Health | Public Health or Welfare | 71 Case Ave, Suite H100, Trenton, GA 30752 | 2006-10-18 |
| 1164435954 | Denis L Mcdonald | Optometrist | 5377 Hwy 136, Trenton, GA 30752 | 2006-08-14 |
| Find all providers in zip 30752 | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
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| 1629618681 | Butler County Community Health Consortium, Inc. | Clinic/Center | 3045 Busenbark Rd Ste B, Trenton, OH 45067-7611 | 2020-01-08 |
| 1639713068 | Henry J Austin Health Center, Inc. | Clinic/Center | 218 N Broad St, Trenton, NJ 08608-1306 | 2019-10-29 |
| 1215446232 | Iron Recovery and Wellness Center, Inc. | Clinic/Center | 132 Perry St, Trenton, NJ 08618-3968 | 2017-09-21 |
| 1063883882 | Henry J Austin Health Center Inc | Clinic/Center | 10 Southard St, Trenton, NJ 08609-1020 | 2015-10-20 |
| 1053782870 | Henry J. Austin Health Center At Family Guidance Center Corporation | Clinic/Center | 2300 Hamilton Ave, Trenton, NJ 08619-3051 | 2015-10-20 |
| 1124499942 | Henry J.austin Health Center At The Rescue Mission of Trenton | Clinic/Center | 98 Carroll St, Trenton, NJ 08609-1008 | 2015-10-20 |
| 1710161823 | Henry J Austin Health Center, Inc | Clinic/Center | 317 Chambers St, Trenton, NJ 08609-2603 | 2007-12-26 |
| Find all providers in TRENTON | ||||
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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.