The Healthcare Authority of Elba, Alabama

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

10489 Issued in AL

Legal business name

THE HEALTHCARE AUTHORITY OF ELBA, ALABAMA

Doing business as

Elba Nursing Home

Practice address

987 Drayton Ave
Elba, AL 36323-1402

Phone

(334) 897-2257

Fax

(334) 897-1213

NPI assigned

Sep 12, 2005

Last updated

Aug 11, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Ellen C Briley, RNLNHA

Title

Administrator

Phone

(334) 897-2257

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Elba Nursing Home Doing business as

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Glenn A Roberts, D.O.

  • Family Medicine Physician
  • Goldsboro, NC
  • NPI 1508849852
  NPD (past)
• Jason David Tucker, MD

  • Sports Medicine Podiatrist
  • Charlotte, NC
  • NPI 1689839813
  NPD (past)

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

{
    "created_epoch": "1126483200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1249948800000",
    "number": "1013902576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "987 DRAYTON AVE",
            "city": "ELBA",
            "state": "AL",
            "postal_code": "363231402",
            "telephone_number": "334-897-2257",
            "fax_number": "334-897-1213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "987 DRAYTON AVE",
            "city": "ELBA",
            "state": "AL",
            "postal_code": "363231402",
            "telephone_number": "334-897-2257",
            "fax_number": "334-897-1213"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE HEALTHCARE AUTHORITY OF ELBA, ALABAMA",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-12",
        "last_updated": "2009-08-11",
        "status": "A",
        "authorized_official_last_name": "BRILEY",
        "authorized_official_first_name": "ELLEN",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "334-897-2257",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "RNLNHA"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "AL",
            "license": "10489",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "47-50830S",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Elba Nursing Home",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Southeast Pharmaceuticals, Inc.
• State of Alabama Department of Public Health (Coffee County Health Dept Flu-Pneu)
• Kenneth D. Strong, O.D.
• The Health Care Authority of Elba Alabama (Elba General Hospital)
• The Healthcare Authority of Elba Alabama (Joyce P. Goetsch, MD)
• Kristi Williams, RBT
• Taylor Renee Zito

• Skilled Nursing Facility in Elba, AL
• Providers in Elba, AL by specialty
• Skilled Nursing Facility in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2009; 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.