| East Georgia Healthcare Center, Inc. | |
|
215 N Coleman St Swainsboro GA 30401-3530 | |
| (478) 237-6262 | |
| (478) 237-9138 |
| Full Name | East Georgia Healthcare Center, Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 215 N Coleman St, Swainsboro, Georgia |
| Authorized Official Name and Position | Jennie Wren Denmark (CEO) |
| Authorized Official Contact | 4782376262 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| East Georgia Healthcare Center, Inc. 215 N Coleman St Swainsboro GA 30401-3530 Ph: (478) 237-6262 | East Georgia Healthcare Center, Inc. 215 N Coleman St Swainsboro GA 30401-3530 Ph: (478) 237-6262 |
| NPI Number | 1831144971 |
|---|---|
| Provider Enumeration Date | 05/24/2006 |
| Last Update Date | 10/23/2012 |
| Medicare PECOS PAC ID | 0547228686 |
|---|---|
| Medicare Enrollment ID | O20050722000569 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831144971 | NPI | - | NPPES |
| 000632376A | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
| Provider Name | Mary Louise Sparkes |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1891737441 PECOS PAC ID: 9335044650 Enrollment ID: I20040720001501 |
| Provider Name | Gerald B Holsonback |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1134132574 PECOS PAC ID: 4183699523 Enrollment ID: I20040830000827 |
| Provider Name | Floyd A Soriano |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1306845433 PECOS PAC ID: 7113980830 Enrollment ID: I20041104000439 |
| Provider Name | Michael Austin |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1134155153 PECOS PAC ID: 3870543861 Enrollment ID: I20050127000429 |
| Provider Name | Kathryn E Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356458954 PECOS PAC ID: 6305890559 Enrollment ID: I20050310000150 |
| Provider Name | Carol C Simmons |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750397527 PECOS PAC ID: 2769419357 Enrollment ID: I20050726000355 |
| Provider Name | Bob Herbert Barrett |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1073598348 PECOS PAC ID: 4082630132 Enrollment ID: I20051021000010 |
| Provider Name | Mark A Haddock |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1518188713 PECOS PAC ID: 6406953363 Enrollment ID: I20070530000013 |
| Provider Name | Joseph C Clifton |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1922143536 PECOS PAC ID: 2567520992 Enrollment ID: I20081029000051 |
| Provider Name | Martin R Sheldon |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1104895374 PECOS PAC ID: 5294787925 Enrollment ID: I20100324000110 |
| Provider Name | Emily Jane Tatum |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1760565279 PECOS PAC ID: 3274614383 Enrollment ID: I20100903000571 |
| Provider Name | Jean M Bailey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376896670 PECOS PAC ID: 2668624438 Enrollment ID: I20121203000066 |
| Provider Name | Jeuslyn Chandler |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1356680359 PECOS PAC ID: 8224271374 Enrollment ID: I20130821000614 |
| Provider Name | Sreevalli Dega |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1023247731 PECOS PAC ID: 6709057953 Enrollment ID: I20131203001749 |
| Provider Name | Lynn Allmond |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396973749 PECOS PAC ID: 2567699192 Enrollment ID: I20131205001235 |
| Provider Name | Alexandra B Weathersby |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851790216 PECOS PAC ID: 9830414168 Enrollment ID: I20150209001764 |
| Provider Name | Kyle Cannady |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457733826 PECOS PAC ID: 8426354069 Enrollment ID: I20160308002755 |
| Provider Name | Carolyn J Jones |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548638877 PECOS PAC ID: 2466730338 Enrollment ID: I20161027000611 |
| Provider Name | Lorene Davis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922468263 PECOS PAC ID: 3476831074 Enrollment ID: I20161102002204 |
| Provider Name | Teresa L Buckles |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588104715 PECOS PAC ID: 7315223153 Enrollment ID: I20170411000867 |
| Provider Name | Billie S Stout |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114459567 PECOS PAC ID: 4183992357 Enrollment ID: I20170612000997 |
| Provider Name | Stephanie Cothern |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871036319 PECOS PAC ID: 3173806668 Enrollment ID: I20170627002749 |
| Provider Name | Beverly A Knighten |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1205940509 PECOS PAC ID: 4880945963 Enrollment ID: I20180928002726 |
| Provider Name | Phyllis Dixon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659865087 PECOS PAC ID: 1355694704 Enrollment ID: I20181031003394 |
| Provider Name | Sharon J Carter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174064851 PECOS PAC ID: 9931443983 Enrollment ID: I20181203002650 |
| Provider Name | Laurie Hutchins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780179390 PECOS PAC ID: 0143565432 Enrollment ID: I20181213003012 |
| Provider Name | Phyllis E Solomon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306337332 PECOS PAC ID: 3971841602 Enrollment ID: I20190205001670 |
| Provider Name | Myiesha Mcfarlin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164032017 PECOS PAC ID: 7517384498 Enrollment ID: I20200825000515 |
| Provider Name | Pamela Sheldon |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1811396005 PECOS PAC ID: 6608270004 Enrollment ID: I20210806002249 |
| Provider Name | Ricky B Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841860541 PECOS PAC ID: 8527463348 Enrollment ID: I20210817002744 |
| Provider Name | Tekisha Jones |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881299469 PECOS PAC ID: 1355732744 Enrollment ID: I20211218000097 |
| Provider Name | Kimberly Tillman Fulmer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780348060 PECOS PAC ID: 2567847577 Enrollment ID: I20220912001986 |
| Provider Name | Paige Neely |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780307876 PECOS PAC ID: 4082070438 Enrollment ID: I20230510001254 |
| Provider Name | Giselle Campos |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861121782 PECOS PAC ID: 6204293335 Enrollment ID: I20230606001199 |
| Provider Name | Tonia Rana Salazar |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184341638 PECOS PAC ID: 1052773157 Enrollment ID: I20230821002535 |
| Provider Name | Jamye Bellamy Clark |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073291613 PECOS PAC ID: 8426403437 Enrollment ID: I20231011002879 |
| Provider Name | Polly Robinson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902669401 PECOS PAC ID: 5890134373 Enrollment ID: I20240430001603 |
| Provider Name | Morgan Royal Comstock |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083476162 PECOS PAC ID: 0244772671 Enrollment ID: I20240612003705 |
Emanuel Prompt Care Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 131 Victory Dr, Swainsboro, GA 30401 Phone: 478-289-1376 | |
Ray Medical Clinic Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 401 W Main St, Swainsboro, GA 30401 Phone: 478-237-9928 Fax: 478-237-4517 | |
Emanuel Pediatrics Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 125 Victory Dr, Swainsboro, GA 30401 Phone: 478-289-1374 Fax: 478-289-1300 | |
East Georgia Healthcare Center, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 258 Tiger Trl, Swainsboro, GA 30401 Phone: 478-237-2638 Fax: 478-237-9138 | |
Emanuel County Hospital Authority Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 117 Kite Rd Ste B, Swainsboro, GA 30401 Phone: 478-289-1100 | |
Smith Rural Health Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 114 S Jefferson St, Swainsboro, GA 30401 Phone: 478-237-7517 Fax: 478-237-4299 | |
Swainsboro Internal Medicine Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 131a Victory Dr, Swainsboro, GA 30401 Phone: 478-237-8342 Fax: 478-237-8281 |