| Jasper Memorial Hospital | |
|
898 College St Monticello GA 31064-1261 | |
| (706) 468-6411 | |
| (706) 468-9880 |
| Full Name | Jasper Memorial Hospital |
|---|---|
| Speciality | General Acute Care Hospital |
| Location | 898 College St, Monticello, Georgia |
| Authorized Official Name and Position | Robert Cumbie (CEO) |
| Authorized Official Contact | 7064684595 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jasper Memorial Hospital 898 College St Monticello GA 31064-1261 Ph: (706) 468-6411 | Jasper Memorial Hospital 898 College St Monticello GA 31064-1261 Ph: (706) 468-6411 |
| NPI Number | 1225031750 |
|---|---|
| Provider Enumeration Date | 05/30/2005 |
| Last Update Date | 10/25/2023 |
| Medicare PECOS PAC ID | 7214901230 |
|---|---|
| Medicare Enrollment ID | O20040824001236 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225031750 | NPI | - | NPPES |
| CH9580 | Other | GA | RAILROAD MEDICARE |
| 00000998A | Medicaid | GA |
| Provider Name | Laura B Moore |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1619926177 PECOS PAC ID: 9133106735 Enrollment ID: I20040701000885 |
| Provider Name | Derrick F Lane |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1124079447 PECOS PAC ID: 3577502186 Enrollment ID: I20050503000132 |
| Provider Name | Nicole E Ross |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1740204171 PECOS PAC ID: 0345244497 Enrollment ID: I20060905000205 |
| Provider Name | Nataliya A Kubasova |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1942563770 PECOS PAC ID: 4486870433 Enrollment ID: I20150914002291 |
| Provider Name | Andrew William Odegaard |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1669095790 PECOS PAC ID: 7810302056 Enrollment ID: I20230921003866 |
W Kenny Blake Md Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 545 Venture Court, Monticello, GA 31064 Phone: 706-468-7002 Fax: 706-468-7020 | |
Venture Medical Associates Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 545 Venture Ct, Monticello, GA 31064 Phone: 706-468-7002 Fax: 706-468-7020 | |
Jameson A Estes, Md, Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 545 Venture Ct, Monticello, GA 31064 Phone: 706-468-7002 | |
Shannon T. Barton Md Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 545 Venture Court, Monticello, GA 31064 Phone: 706-468-7002 Fax: 706-468-7020 |