The Nathaniel Watson, Jr. Memorial Foundation, Inc

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

Legal business name

THE NATHANIEL WATSON, JR. MEMORIAL FOUNDATION, INC

Practice address

506 Calgary Glen Drive SW
Austell, GA 30168-7284

Phone

(770) 770-9196

Fax

(770) 732-0739

NPI assigned

Jul 2, 2006

Organization subpart

Yes

Parent organization

THE NATHANIEL WATSON, JR. MEMORIAL FOUNDATION, INCAs reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ms. Valerie Watson-Baxter

Title

Ceo

Phone

(770) 693-8852

Specialties & licenses 2

Addresses

Other names 1

• Balm of Gilead Medical Services Doing business as

Part of

The Nathaniel Watson Jr Memorial Foundation Inc

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1151798400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1220918400000",
    "number": "1003845967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "506 CALGARY GLEN DRIVE SW",
            "city": "AUSTELL",
            "state": "GA",
            "postal_code": "301687284",
            "telephone_number": "770-732-9196",
            "fax_number": "770-770-0739"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "506 CALGARY GLEN DRIVE SW",
            "city": "AUSTELL",
            "state": "GA",
            "postal_code": "301687284",
            "telephone_number": "770-770-9196",
            "fax_number": "770-732-0739"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE NATHANIEL WATSON, JR. MEMORIAL FOUNDATION, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "THE NATHANIEL WATSON, JR. MEMORIAL FOUNDATION, INC",
        "enumeration_date": "2006-07-02",
        "last_updated": "2008-09-09",
        "status": "A",
        "authorized_official_last_name": "WATSON-BAXTER",
        "authorized_official_first_name": "VALERIE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "770-693-8852",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "3140N1450X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility, Nursing Care, Pediatric",
            "state": "GA",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Balm of Gilead Medical Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.