PEACHSTATE PSYCHIATRIC SERVICES, INC. (NPI# 1922230648) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1922230648 |
| Entity Type | Organization |
| Organization Name | PEACHSTATE PSYCHIATRIC SERVICES, INC. |
| Practice Address |
1720 Peachtree St Nw Ste 640 Atlanta GA 30309-2450 |
| Practice Telephone | 4045754785 |
| Mailing Telephone | 4045754785 |
| Enumeration Date | 2009-08-13 |
| Last Update Date | 2009-08-13 |
| Authorized Official Name | DR. DWIGHT A. OWENS (OWNER) |
| Authorized Official Telephone | 4045754785 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 273R00000X | Psychiatric Unit | 080408LGB | GA | Hospital Units |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| VALUE OPTIONS | 162363 | 01 | |
| GA | AETNA | 7698253 | 01 |
| GA | MAGELLAN GROUP | 80440600 | 01 |
| MAGELLAN PERSONAL | 278688000 | 01 | |
| MEDICAID GBH | 000851309A | 01 | |
| WELLCARE MEDICARE | 26BDHBD | 01 | |
| WELLCRE MEDICAID | 27868800 | 01 | |
| GA | BC/BS GEORGIA | 52806851 | 01 |
| AMERIGROUP | 713313717 | 01 | |
| UBH/EVERCARE | 102379467 | 01 | |
| OWCP | 158479400 | 01 | |
| BC/BS PLAN LOCATOR | 52806851 | 01 | |
| GA | CLARENCE5 | 05 |
| Street Address |
1720 PEACHTREE ST NW STE 640 |
| City | ATLANTA |
| State | GA |
| Zip Code | 30309-2450 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275184715 | Bolanle Olayinka Babajide-gbenga | Nurse Practitioner | 1720 Peachtree St Nw Ste 640, Atlanta, GA 30309-2450 | 2019-09-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396382354 | Astoria Dentistry LLC | Dentist | 2233 Peachtree Rd. Nw, Suite 300, Atlanta, GA 30309 | 2019-12-09 |
| 1487133740 | S2 Telehealth Technologies, LLC | Psychiatry & Neurology | 915 W Peachtree St Nw Apt 522, Atlanta, GA 30309 | 2018-08-08 |
| 1841782620 | Janie Mardis | Social Worker | 3 Park Ln Ne, Apt H, Atlanta, GA 30309 | 2018-06-06 |
| 1083102842 | Veronica L Bentley | Specialist/Technologist, Other | 1170 Peachtree Street Suite 1200, Atlanta, GA 30309 | 2018-04-27 |
| 1427566363 | Net Medical Corp | Chiropractor | 1100 Spring St Sw, Ste#700, Atlanta, GA 30309 | 2018-01-12 |
| 1871000463 | Mary James (jamie) Johnson | Counselor | 1100 Spring Street, Suite 380, Atlanta, GA 30309 | 2018-01-04 |
| 1306377817 | Aliyah Lamis Scott | Social Worker | 1745 Peachtree Road Ne, Kaiser Permanente Brookwood Medical Office, Atlanta, GA 30309 | 2017-03-26 |
| 1013450774 | Caroline Hallen | Nurse Practitioner | 105 Collier Rd Nw Suite 3040, Atlanta, GA 30309 | 2016-11-29 |
| 1528501723 | Ant-aging Queen | Nutritionist | 1801 Atlanta Medical Clinic, Suite 250, Atlanta, GA 30309 | 2016-11-21 |
| 1790231439 | Nurse 2 Health Home Care LLC | Home Health | 1075 Peachtree Street Ne, Atlanta, GA 30309 | 2016-09-01 |
| Find all providers in zip 30309 | ||||
| Taxonomy Code | 273R00000X |
| Grouping | Hospital Units |
| Classification | Psychiatric Unit |
| In general, a distinct unit of a hospital that provides acute or long-term care to emotionally disturbed patients, including patients admitted for diagnosis and those admitted for treatment of psychiatric problems on the basis of physicians' orders and approved nursing care plans. Long-term care may include intensive supervision to the chronically mentally ill, mentally disordered or other mentally incompetent persons; (2) For Medicare, a distinct part of a general acute care hospital admitting only patients whose admission to the unit is required for active treatment, whose treatment is of an intensity that can be provided only in an inpatient hospital setting, and whose condition is described by a psychiatric principal diagnosis contained in the Third Edition of the American Psychiatric Association Diagnostic and Statistical Manual or in Chapter 5 (Mental Disorders) of the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM). The unit must furnish, through the use of qualified personnel, psychological services, social work services, psychiatric nursing, occupational therapy, and recreational therapy. The unit must maintain medical records that permit determination of the degree and intensity of treatment provided to individuals who are furnished services in the unit; the unit must meet special staff requirements in that the unit must have adequate numbers of qualified professional and supportive staff to evaluate inpatients, formulate written, individualized, comprehensive treatment plans, provide active treatment measures and engage in discharge planning. |
| Notes: Source: (1) AHA Annual Survey p. A10 1996 AHA Guide; (2) Code of Federal Regulations #42, Section 412.27. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891061313 | Christus Health Ark-la-tex | Psychiatric Unit | 1007 S William St, Atlanta, TX 75551-3245 | 2012-03-29 |
| 1629297478 | Grady Memorial Hospital Corporation | Psychiatric Unit | 80 Jesse Hill Jr Dr, Se, Atlanta, GA 30303-3050 | 2007-04-24 |
| 1558443085 | Atlanta Hospital Authority | Psychiatric Unit | 1007 S William St, Atlanta, TX 75551-3245 | 2006-10-20 |
| 1528093960 | Wellstar Atlanta Medical Center, Inc | Psychiatric Unit | 303 Parkway Dr Ne, Atlanta, GA 30312-1212 | 2006-07-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982634572 | Gwinnett Hospital System, Inc. | Psychiatric Unit | 250 Scenic Hwy, Lawrenceville, GA 30045-5675 | 2006-07-03 |
| 1730123431 | John D. Archbold Memorial Hospital, Inc. | Psychiatric Unit | 401 Old Albany Rd, Thomasville, GA 31792-4014 | 2006-06-15 |
| 1023057775 | Floyd Healthcare Management Inc | Psychiatric Unit | 306 Shorter Ave Nw, Rome, GA 30165-4268 | 2006-06-06 |
| 1760436810 | Coliseum Medical Center, LLC | Psychiatric Unit | 340 Hospital Drive, Macon, GA 31217 | 2006-05-22 |
| 1902453111 | Sedzer Health LLC | Psychiatric Unit | 931 E Winthrope Ave, Millen, GA 30442-1839 | 2019-08-22 |
| 1578026431 | South Atlanta Psychiatry LLC | Psychiatric Unit | 253 Upper Riverdale Rd Sw Ste C, Riverdale, GA 30274-4945 | 2019-04-08 |
| 1518440254 | Prime Healthcare Foundation - Southern Regional, LLC | Psychiatric Unit | 11 Upper Riverdale Rd Sw, Riverdale, GA 30274-2615 | 2018-09-10 |
| 1831602903 | Savannah Health Services, LLC | Psychiatric Unit | 4700 Waters Ave, Savannah, GA 31404-6220 | 2017-11-13 |
| 1225559610 | Upson County Hospital Inc | Psychiatric Unit | 801 W Gordon St, Thomaston, GA 30286-3426 | 2017-07-06 |
| 1861926438 | Evans Memorial Hospital, Inc. | Psychiatric Unit | 200 N River St, Claxton, GA 30417-1659 | 2017-04-20 |
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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.