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PSHP Prterrlist Revised 08012017

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PSHP Prterrlist Revised 08012017 Albany Atlanta Macon 2810 Meredyth Drive 1100 Circle 75 Parkway 577 Mulberry Street Suite B Suite 1100 5th Floor, Suite 580 Albany, Georgia 31707 Atlanta, Georgia 30339 Macon, GA 31202 Main: 229-430-5829 Main: 678-556-2300 Main: 478-738-8540 Provider Solutions Department – Territory List Provider Solutions Territories Contact/Fax Numbers Team & Email Addresses Lanitra Perry Office: 678-556-2470 Manager East & North Regions Fax: 877-683-3155 East & North Regions Email: [email protected] Banks, Barrow, Clarke, Elbert, Forsyth, Franklin, Habersham, Hall, Office: 678-556-2307 Nicole Keyser Hart, Jackson, Madison, Morgan, Oconee, Oglethorpe, Rabun, Fax: 877-683-3155 Specialist Stephens, Walton, White Email: [email protected] North Region Group Accounts: Barrow Hospital, Mountain Lakes Medical Center, CAAP, Clearview Regional, Longstreet Clinic, Northeast Georgia Physician Group, St Mary’s Hospital DME/Home Health: Barrow, Bartow, Carroll, Cobb, Cherokee, Douglas, Gwinnett, Forsyth, Paulding, Pickens Bartow, Catoosa, Chatooga, Cherokee, Dade, Dawson, Fannin, Melissa Smith Floyd, Gilmer, Gordon, Lumpkin, Murray, Pickens, Polk, Towns, Office: 706-331-8029 Specialist Union, Walker, Whitfield, North Carolina, NE Alabama and Fax: 877-683-3155 North Region Tennessee Email: Group Accounts: Erlanger, Floyd Hospital, Floyd Physician [email protected] Group, HOA Burke, Columbia, Emanuel, Greene, Hancock, Jefferson, Jenkins, Office: 770-807-4544 Lincoln, McDuffie, Putnam, Richmond, Taliaferro, Warren, Shikira Coley Fax: 877-683-3155 Specialist Washington, Wilkes, South Carolina Email: [email protected] East Region Group Accounts: PPG/AU Medical Associates, Doctors Hospital, JMS Burn Center, Washington County Regional Medical Ctr. DME/Home Health – Butts Clayton, Coweta, DeKalb, Fayette, Fulton, Henry, Jasper, Newton, Rockdale, Spalding Keive Dixon Office: 678-556-2308 Sr. Manager Atlanta Region Fax: 877-683-3155 A tlanta Region Email: [email protected] Lisa Bender DeKalb Office: 478-278-1955 Specialist Group Accounts: DeKalb PHO, DeKalb Hospital, Kids Health Fax: 877-683-3155 Atlanta Region First, Village Podiatry Email: [email protected] Office: 678-767-9358 Kelli Austin Carroll, Cobb, Douglas, North Fulton and Paulding Fax: 877-683-3155 Specialist Group Accounts: Healthwest PHO, Tanner Health System, Email: [email protected] Atlanta Region Tenet/Spalding PHO Gwinnett Danielle Walton Group Accounts: Gwinnett PHO, Gwinnett Medical Center, Office: 678-556-2459 Specialist Fax: 877-683-3155 WellStreet Clinic, IMPACT Atlanta Region Email: [email protected] Blanca Rodriguez-Russell South Fulton Office: 678-556-2246 Supervisor Group Accounts: Emory, Grady, Morehouse, Soft Touch, Fax: 855-286-1806 Provider Network A Supreme Nursing Email: [email protected] General Inquiries Out of Network Physicians & Facilities Office: 866-874-0633 Emergency Room Physicians [email protected] Hospitalists PSHP_PRTerrList_Revised 08012017 Albany Atlanta Macon 2810 Meredyth Drive 1100 Circle 75 Parkway 577 Mulberry Street Suite B Suite 1100 5th Floor, Suite 580 Albany, Georgia 31707 Atlanta, Georgia 30339 Macon, GA 31202 Main: 229-430-5829 Main: 678-556-2300 Main: 478-738-8540 Provider Solutions Department – Territory List Provider Solutions Territories Contact/Fax Numbers Team & Email Addresses Tottianna Thomas Butts, Clayton, Henry Office: 678-556-2300 Specialist Group Accounts: TCHN IPA, Pediatrix, Piedmont Physician Fax: 877-683-3155 Atlanta Region Group, Walgreens Email: [email protected] Keive Dixon Jasper, Newton and Rockdale Office: 678-556-2308 Sr. Manager Group Accounts: Atlanta Gastroenterology Associates, ENT of Fax: 877-683-3155 Atlanta Region Georgia, Kaiser, Northside Physician Group, Shepherd Center, Email: [email protected] Tri-Alliance Montia Fleming Coweta, Fayette, Spalding Office: 678-556-2479 Specialist Group Accounts: CHOA, HCA, WellStar Hospital, Northside Fax: 877-683-3155 Atlanta Region Hospital, Piedmont Hospital, Rockdale Hospital, Southern Email: [email protected] Regional Hospital Jeffrey West Central Region Office: 478-738-8542 Manager Group Accounts: Medical Center of Central Georgia, Fax: 855-475-4401 Central Region Central Georgia Health Network Email: [email protected] Baldwin, Bibb, Bleckley, Crisp, Dooly, Dodge, Houston, Johnson, Jennifer Worsham Laurens, Macon, Peach, Pulaski, Telfair, Treutlen, Twiggs, Office: 478-738-8541 Specialist Wheeler, Wilcox, Wilkinson Fax: 855-475-4401 Email: Central Region Group Accounts: Houston Healthcare, Eastman Pediatric Clinics, Primary Pediatrics of Macon, CGMCN [email protected] Chattahoochee, Crawford, Harris, Heard, Jones, Lamar, Marion, Jennifer Morris Meriwether, Monroe, Muscogee, Pike, Talbot, Taylor, Troup, Office: 478-738-8550 Specialist Upson, Phenix City (AL), Smith Station (AL), Auburn (AL) Fax: 855-475-4401 Central Region Group Accounts: The Medical Center, Inc. (Columbus), Email: [email protected] West Georgia Medical Center, Children’s Clinic of Lagrange, Columbus Physician Associates (CPA), MyHealth Brittney Mathis Southwest Region Office: 229-430-5851 Sr. Manager Group Accounts: Phoebe Physician Group, Phoebe Health Fax: 866-753-5773 Southwest Region Partners Email: [email protected] Baker, Calhoun, Clay, Colquitt, Dougherty, Early, Lee, Miller, Carol Jackson Quitman, Randolph, Schley, Stewart, Sumter, Terrell, Tift, Turner, Office: 229-430-5829 Specialist Webster, Worth, Eufaula & Dothan (AL), Tallahassee (FL) Fax: 866-753-5773 Southwest Region Group Accounts: Kids Care Clinic, Sumter Pediatrics, Children’s Email: [email protected] Medical Group, Colquitt Regional Medical, Children’s Medical & Moultrie Medical Group, Tift Affinity Group, SGPA Sarah Sanders Atkinson, Ben Hill, Berrien, Brooks, Clinch, Coffee, Cook, Decatur, Office: 229-430-5852 Specialist Echols, Grady, Irwin, Lanier, Lowndes, Mitchell, Seminole, Fax: 866-753-5773 Southwest Region Thomas Email: Group Accounts: Amelia Medical Plaza, The Pediatric Center, [email protected] Archbold Medical Center & Medical Group, SGMC, South Georgia Pediatrics and Allergy, Valdosta Children’s Healthcare, Memorial Pediatrics Office: 866-874-0633 General Inquiries Out of Network Physicians & Facilities Emergency Room Physicians, Hospitalists [email protected] PSHP_PRTerrList_Revised 08012017 Albany Atlanta Macon 2810 Meredyth Drive 1100 Circle 75 Parkway 577 Mulberry Street Suite B Suite 1100 5th Floor, Suite 580 Albany, Georgia 31707 Atlanta, Georgia 30339 Macon, GA 31202 Main: 229-430-5829 Main: 678-556-2300 Main: 478-738-8540 Provider Solutions Department – Territory List Provider Solutions Territories Contact/Fax Numbers Team & Email Addresses Brantley, Bryan, Camden, Charlton, Glynn, Liberty, Long, McIntosh, Lasha Moore Office: 912-339-7166 Pierce, Ware, Wayne Manager Fax: 866-753-5773 Group Accounts: Memorial Health Partners, Camden Healthcare Southeast Region Email: [email protected] Network, St Joseph Candler Hospital, St Joseph Employed Physicians Group, Southeast Georgia Health System, ABC Pediatrics Office: 678-206-8425 Akia Braxton Appling, Bacon, Bulloch, Candler, Chatham, Effingham, Evans, Jeff Fax: 866-753-5773 Specialist Davis, Montgomery, Screven, Tattnall, Toombs Email : Southeast Region Group Accounts: East Georgia Regional Hospital, Hazelhurst [email protected] Pediatrics, Optim Open Position Statewide Email: [email protected] Manager Group Accounts: FQHC Accounts FQHC Office: 678-556-2313 Victoria Scott Statewide Fax: 877-683-3155 Supervisor Group Accounts: FQHC Accounts FQHC Email: [email protected] Mobile: 770-543-8791 Statewide Elizabeth Brawner, CPhT Fax: 886-374-1579 Pharmacy Provider Liaison Email: [email protected] Office: 678-556-2491 Statewide Daniel Scott, CPhT Mobile: 678-580-7949 Pharmacy Provider Liaison Fax: 866-374-1579 Email: [email protected] Statewide Office: 770-370-4445 Lucretia Bell Fax: 855-286-1806 Project Coordinator Email: [email protected] Statewide Office: 770-743-3216 Errol Wade Fax: 855-286-1806 Project Coordinator Email: [email protected] Office: 770-437-3014 Statewide Monika Place Fax: 855-286-1806 Project Coordinator Email: [email protected] Office: 866-874-0633 General Inquiries Out of Network Physicians & Facilities [email protected] Emergency Room Physicians, Hospitalists PSHP_PRTerrList_Revised 08012017 .
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