Grady Health System

Primary specialty

Critical Access HospitalTaxonomy code 282NC0060X

License

161834 Issued in GA

Legal business name

GRADY HEALTH SYSTEM

Practice address

180 Victoria Dr
Fayetteville, GA 30214-1163

Phone

(404) 379-7052

NPI assigned

Dec 26, 2010

Organization subpart

No

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

Authorized official

Name

Mrs. Latoya Booth Wise, CRNA

Title

Anesthetist

Phone

(404) 379-7052

Specialties & licenses 1

Addresses

Interoperability endpoints

• FHIR API: https://surescripts.gmh.edu/OAuth2PRD/GHSMYC/api/FHIR/R4/

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Latoya Leigh Wise, CRNA

  • Certified Registered Nurse Anesthetist
  • Fayetteville, GA
  • NPI 1831456284
  NPD (past)

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

{
    "created_epoch": "1293321600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1293321600000",
    "number": "1013211564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "180 VICTORIA DR",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302141163",
            "telephone_number": "404-379-7052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "180 VICTORIA DR",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302141163",
            "telephone_number": "404-379-7052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRADY HEALTH SYSTEM",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-26",
        "last_updated": "2010-12-26",
        "status": "A",
        "authorized_official_last_name": "WISE",
        "authorized_official_first_name": "LATOYA",
        "authorized_official_middle_name": "BOOTH",
        "authorized_official_title_or_position": "ANESTHETIST",
        "authorized_official_telephone_number": "404-379-7052",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "CRNA"
    },
    "taxonomies": [
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": "GA",
            "license": "161834",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marysue C Goza, M.D.
• Sara H. Goza, M.D.
• Wendy Smith Goza, M.D.
• Graceful Handz Salon LLC
• Kristen Dawn Graddy, OTR/L
• Lisa Graefinger, PHARM D
• Nancy Welch Graf, PA-C
• Graham Family Adult Daycare Inc.
• Erica Graham
• Norman Graham

• Critical Access Hospital in Fayetteville, GA
• Providers in Fayetteville, GA by specialty
• Critical Access Hospital in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2010; 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.