STEPHENS COUNTY HOSPITAL PHYSICIAN GROUP LLC (NPI# 1659761955) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1659761955 |
| Entity Type | Organization |
| Organization Name | STEPHENS COUNTY HOSPITAL PHYSICIAN GROUP LLC |
| Practice Address |
163 Hospital Dr Toccoa GA 30577-6820 |
| Practice Telephone | 7062824200 |
| Practice Fax Number | 7068868045 |
| Mailing Telephone | 7062824200 |
| Mailing Fax Number | 7068868045 |
| Enumeration Date | 2015-01-26 |
| Last Update Date | 2020-06-19 |
| Authorized Official Name | MICHAEL HESTER (CEO) |
| Authorized Official Telephone | 7062824200 |
| Is Organization Subpart | Y |
| Parent Organization Name | STEPHENS COUNTY HOSPITAL AUTHORIT |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208600000X | Surgery | Allopathic & Osteopathic Physicians | ||
| Y | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians |
| Street Address |
163 HOSPITAL DR |
| City | TOCCOA |
| State | GA |
| Zip Code | 30577-6820 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346230851 | Matthew William Kervin | Nurse Anesthetist, Certified Registered | 163 Hospital Dr, Toccoa, GA 30577-6820 | 2005-10-26 |
| 1568074615 | James Christopher Beck | Physician Assistant | 163 Hospital Dr, Toccoa, GA 30577-6820 | 2020-08-20 |
| 1023655321 | Stephens County Hospital Authority | Medicare Defined Swing Bed Unit | 163 Hospital Dr, Toccoa, GA 30577-6820 | 2019-12-05 |
| 1770078032 | Southland Stephens Hospitalist Group, LLC | Hospitalist | 163 Hospital Dr, Toccoa, GA 30577-6820 | 2018-06-28 |
| 1205342367 | Southland Stephens Emergency Medical Services, LLC | Emergency Medicine | 163 Hospital Dr, Toccoa, GA 30577-6820 | 2017-12-26 |
| 1457755274 | Jerlene Lawrence | Nurse Practitioner | 163 Hospital Dr, Toccoa, GA 30577-6820 | 2014-10-22 |
| 1760811616 | Hannah Andre Goodbar | Occupational Therapist | 163 Hospital Dr, Toccoa, GA 30577-6820 | 2013-11-01 |
| 1053698613 | Enrique Puertos | Pharmacist | 163 Hospital Dr, Toccoa, GA 30577-6820 | 2011-11-10 |
| 1073890075 | Curt Matthew Vanorman | Pharmacist | 163 Hospital Dr, Toccoa, GA 30577-6820 | 2011-11-04 |
| 1073708129 | Stephens County Ambulance Service | Ambulance | 163 Hospital Dr, Toccoa, GA 30577-6820 | 2007-09-12 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982220513 | Jennifer Lynn Harper | Counselor | 46 Rice Lewis Gilliard Way, Toccoa, GA 30577 | 2020-06-19 |
| 1912528696 | Pittard Clinic LLC | Clinic/Center | 1654 Falls Rd, Toccoa, GA 30577 | 2020-05-04 |
| 1518313733 | Shellei Adams | Occupational Therapist | 23 Big A Rd, Toccoa, GA 30577 | 2016-05-06 |
| 1902212814 | Rebecca Coursey | Counselor | 1763 Fernside Dr., Avita Community Partners, Toccoa, GA 30577 | 2014-07-11 |
| 1427478742 | Cynthia Hemphill Wansley | Pharmacist | 3886 Georgia Highway 17, Toccoa, GA 30577 | 2014-04-25 |
| 1265850168 | Karen Kelley Colwell | Pharmacist | 3886 Hwy 17, Toccoa, GA 30577 | 2014-03-29 |
| 1972808160 | Cossar Chiropractic | Chiropractor | 2766 Ga Hwy 17, Toccoa, GA 30577 | 2011-01-19 |
| 1811216070 | Georgia Mountains Community Services | Day Training, Developmentally Disabled Services | 130 Haynes St, Toccoa, GA 30577 | 2010-05-26 |
| 1942435516 | Meadows Surgical Arts | Specialist | 203 Remsdale Rd, Toccoa, GA 30577 | 2009-05-26 |
| 1609011816 | Bryan Gerald Wood | Pharmacist | 102 N Sage Street, Stewart's Downtown Discount Drugs, Toccoa, GA 30577 | 2008-12-03 |
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| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174516330 | Marc S Coan | Internal Medicine | 58 Big A Road, Toccoa, GA 30577-6017 | 2005-08-23 |
| 1700860913 | Jim R Wade | Internal Medicine | 58 Big A Road, Toccoa, GA 30577-6017 | 2005-12-01 |
| 1225012446 | Thomas David Yates | Internal Medicine | 58 Big A Rd, Toccoa, GA 30577-6017 | 2005-12-01 |
| 1841283231 | Bhaskerrao Patel | Internal Medicine | 58 Big A Road, Toccoa, GA 30577-6017 | 2005-08-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902407752 | Neighbormd of Atlanta LLC | Internal Medicine | 285 Boulevard Ne Ste 435&436, Atlanta, GA 30312-4205 | 2020-11-06 |
| 1053912907 | Neighbormd of North Atlanta LLC | Internal Medicine | 1800 Peachtree St Nw Ste 730nw, Atlanta, GA 30309-2519 | 2020-11-06 |
| 1285235036 | Neighbormd of South Atlanta LLC | Internal Medicine | 3885 Princeton Lakes Way Sw Ste 412, Atlanta, GA 30331-5599 | 2020-11-06 |
| 1770182586 | Nuberty Inc | Internal Medicine | 227 Sandy Springs Pl Ste 220, Sandy Springs, GA 30328-5935 | 2020-10-22 |
| 1427664333 | Nations Medical Clinic Inc | Internal Medicine | 3099 Bredkinridge Blvd, Suite 110/111, Duluth, GA 30096-1011 | 2020-09-17 |
| 1659986057 | Herman Medical Solutions, LLC | Internal Medicine | 10700 Medlock Bridge Road, Suite 207, Duluth, GA 30097 | 2020-09-11 |
| 1790399475 | Janice Carol Gould | Internal Medicine | 140 Vann St Ne Ste 350, Marietta, GA 30060-8975 | 2020-09-01 |
| 1952914368 | Hardy Renew Wellness,llc | Internal Medicine | 838 Cannon Run Sw, Marietta, GA 30064-4600 | 2020-08-25 |
| 1013529577 | Willy Armand Yougang Tchoutang | Internal Medicine | 120 Stoney Creek Dr, Kathleen, GA 31047-3120 | 2020-08-17 |
| 1841800679 | Om Primary Care LLC | Internal Medicine | 4300 Westbrook Rd Bldg A, Suwanee, GA 30024-4987 | 2020-08-06 |
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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.