GEORGIA MOUNTAINS HEALTH SERVICES, INC (NPI# 1881050508) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1881050508 |
| Entity Type | Organization |
| Organization Name | GEORGIA MOUNTAINS HEALTH SERVICES, INC |
| Practice Address |
500 Green Rd Chatsworth GA 30705-2745 |
| Mailing Address |
165 Blue Ridge Overlook Blue Ridge GA 30513-4431 |
| Practice Telephone | 7065172200 |
| Practice Fax Number | 7065174280 |
| Mailing Telephone | 7069464647 |
| Mailing Fax Number | 7063747628 |
| Enumeration Date | 2016-01-11 |
| Last Update Date | 2020-04-22 |
| Authorized Official Name | STEVEN MIRACLE (CEO) |
| Authorized Official Telephone | 7069465610 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
Ambulatory Health Care Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184035057 | Georgia Mountains Health Services, Inc | Clinic/Center | 1179 Progress Rd, Ellijay, GA 30540-5504 | 2014-05-14 |
| 1285057281 | Georgia Mountains Health Services, Inc | Clinic/Center | 134 Ansley Dr Ste 700, Dahlonega, GA 30533-1641 | 2014-01-27 |
| 1821332495 | Georgia Mountains Health Services, Inc | Clinic/Center | 900 Shugart Rd, Dalton, GA 30720-2467 | 2012-11-20 |
| 1144419813 | Georgia Mountains Health Services, Inc | Clinic/Center | 1008 N 3rd Ave, Chatsworth, GA 30705-2118 | 2007-10-18 |
| 1538123666 | Georgia Mountains Health Services, Inc | Clinic/Center | 165 Blue Ridge Overlook, Blue Ridge, GA 30513-4431 | 2006-04-14 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | GEORGIA MOUNTAINS HEALTH SERVICES, INC. | 165 Blue Ridge Overlook, Blue Ridge, GA 30513-4431 |
| Street Address |
500 GREEN RD |
| City | CHATSWORTH |
| State | GA |
| Zip Code | 30705-2745 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417204132 | Tara Amos Sane | Nurse Practitioner | 500 Green Rd, Chatsworth, GA 30705-2745 | 2012-08-13 |
| 1215454020 | Pamela Jean Key | Nurse Practitioner | 500 Green Rd, Chatsworth, GA 30705-2745 | 2017-08-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821582784 | Kayla Michelle Khan | Dentist | 221 N. 4th Avenue, Chatsworth, GA 30705 | 2018-06-14 |
| 1578079869 | Professional Eye Associates, Inc. | Eyewear Supplier (Equipment, not the service) | 113 West Pine Street, Chatsworth, GA 30705 | 2017-12-21 |
| 1518472778 | Rebecca Annette Lunsford | Case Manager/Care Coordinator | 165 Freedom Way, Chatsworth, GA 30705 | 2017-12-11 |
| 1306214630 | K-va-t Food Stores, Inc. | Durable Medical Equipment & Medical Supplies | 502 Gi Maddox Parkway, Chatsworth, GA 30705 | 2015-09-03 |
| 1003231416 | Jessica Sanders | Nurse Practitioner | 800 Gi Maddox Pwky, Chatsworth, GA 30705 | 2014-02-20 |
| 1063731560 | Travis Mckie-voerste | Counselor | 96 Terrace Ct, Chatsworth, GA 30705 | 2010-05-24 |
| 1609962521 | Charlie Weichen Fang | Emergency Medicine | 707 Old Ellijay Road, Chatsworth, GA 30705 | 2006-10-05 |
| 1619941689 | Murray County Board of Health | Public Health or Welfare | 709 Dalton-ellijay Highway, Chatsworth, GA 30705 | 2006-02-15 |
| 1780671974 | Trom Enterprises, Inc. | Pharmacy | 101 Murray Plaza, Chatsworth, GA 30705 | 2005-10-03 |
| 1518953785 | Yara Fattouh | Family Medicine | 1111 Hwy 76, Chatsworth, GA 30705 | 2005-09-23 |
| Find all providers in zip 30705 | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144419813 | Georgia Mountains Health Services, Inc | Clinic/Center | 1008 N 3rd Ave, Chatsworth, GA 30705-2118 | 2007-10-18 |
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|---|---|---|---|---|
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| 1366066243 | Health Education Assessment and Leadership Inc | Clinic/Center | 225 Griffin St Nw, Atlanta, GA 30314-3917 | 2020-06-05 |
| 1851924377 | Valley Healthcare System | Clinic/Center | 1458 Benning Dr, Columbus, GA 31903-2200 | 2020-02-13 |
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| 1023658523 | Saint Joseph's Mercy Care Services, Inc. | Clinic/Center | 1407 Cobb Parkway Nw, Marietta, GA 30060-6546 | 2020-01-13 |
| 1467092221 | Careconnect Health, Inc. | Clinic/Center | 130 N Lee St, Forsyth, GA 31029-2122 | 2020-01-09 |
| 1417597238 | The Family Health Centers of Georgia, Inc | Clinic/Center | 19 John Maddox Dr Nw Ste B, Rome, GA 30165-1477 | 2020-01-09 |
| 1649810714 | Careconnect Health, Inc. | Clinic/Center | 254 Wright Avenue, Roberta, GA 31078 | 2020-01-07 |
| 1437798725 | Careconnect Health, Inc. | Clinic/Center | 414 S Frontage Rd Lot 53, Forsyth, GA 31029-3025 | 2020-01-03 |
| 1285277608 | Saint Joseph's Mercy Care Services, Inc. | Clinic/Center | 1976 Flat Shoals Rd Se Ste B, Atlanta, GA 30316-2857 | 2019-10-18 |
| Find all providers with the same taxonomy | ||||
| City | CHATSWORTH |
| Zip Code | 30705 |
Please comment or provide details below to improve the information on GEORGIA MOUNTAINS HEALTH SERVICES, INC.
| 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.