JEFF DAVIS HOSPITAL – NPI #1912902263
General Acute Care Hospital

JEFF DAVIS HOSPITAL is a general acute care hospital located in HAZLEHURST, GA. NPPES has assigned the NPI number 1912902263 to JEFF DAVIS HOSPITAL on June 14, 2005. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “JEFF DAVIS HOSPITAL” is a dba name, the actual legal business name for this organization is HOSPITAL AUTHORITY OF JEFF DAVIS COUNTY GEORGIA. The primary taxonomy selected by this provider is 282NC0060X from the Health Care Provider Taxonomy code set, which is classified as General Acute Care Hospital, specializing in Critical Access

The NPI profile was previously updated about 4 years ago on Jul 21, 2022. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for JEFF DAVIS HOSPITAL below.

NPI Profile for
HOSPITAL AUTHORITY OF JEFF DAVIS COUNTY GEORGIA

NPI Number
1912902263
Enumeration Date

(about 21 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
HOSPITAL AUTHORITY OF JEFF DAVIS COUNTY GEORGIA
Doing Business As (dba): JEFF DAVIS HOSPITAL
Primary location
163 S TALLAHASSEE ST
HAZLEHURST, GA 31539-1690
Phone: (912) 375-7781 Fax: (912) 375-4055
Mailing address
PO BOX 1690
HAZLEHURST, GA 31539-1690
Phone: (912) 375-7781 Fax: (912) 375-4055
Organization Subpart
No
Authorized Official
BARRY BLOOM
CEO
Phone: (912) 375-7781
Updated
Certification Date
Jun 23, 2021

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Identifiers

Identifiers for JEFF DAVIS HOSPITAL

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

DescriptionIssuerStateIdentifier
MEDICAIDGA000001009A
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
282NC0060X
- General Acute Care Hospital / Critical Access (Primary)		 GA

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.