NPIMap

Organization Active NPI

Memorial Careone Home Health Services Inc

  • Home Health Agency
  • Waycross, GA
National Provider Identifier
1013925932
Registry record updated Oct 31, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
148110 Issued in GA
Legal business name
MEMORIAL CAREONE HOME HEALTH SERVICES INC
Practice address
203 Albany Ave
Waycross, GA 31501-3504
Phone
(912) 285-2222
Fax
(912) 285-5441
NPI assigned
Aug 4, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2007

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

Authorized official

Name
Ms. Deanna M Wildes, RN
Title
Director of Operations
Phone
(912) 350-6559

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X 148110 GA Primary

Addresses

Primary practice location

203 Albany Ave
Waycross, GA 31501-3504

Mailing address

PO Box 931861
Atlanta, GA 31198-1861
Phone (912) 350-6405

Other identifiers 1

IdentifierTypeStateIssuer
00336861AMedicaidGA

Other names 1

  • CareOne Home Health Services - Waycross Agency Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Careone Home Health Services - Savannah Agency3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1154649600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193788800000",
    "number": "1013925932",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 931861",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "311981861",
            "telephone_number": "912-350-6405",
            "fax_number": "912-350-6413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "203 ALBANY AVE",
            "city": "WAYCROSS",
            "state": "GA",
            "postal_code": "315013504",
            "telephone_number": "912-285-2222",
            "fax_number": "912-285-5441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEMORIAL CAREONE HOME HEALTH SERVICES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-04",
        "last_updated": "2007-10-31",
        "status": "A",
        "authorized_official_last_name": "WILDES",
        "authorized_official_first_name": "DEANNA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "DIRECTOR OF OPERATIONS",
        "authorized_official_telephone_number": "912-350-6559",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "GA",
            "license": "148110",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00336861A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CareOne Home Health Services - Waycross Agency",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Waycross, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2007; 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.