NPIMap

Organization Active NPI

Amelia Gardens Inc

  • Assisted Living Facility
  • Mableton, GA
National Provider Identifier
1023550407
Registry record updated Nov 16, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
License
033-02-028-1 Issued in GA
Legal business name
AMELIA GARDENS INC
Practice address
576 Nickajack Rd SW
Mableton, GA 30126-1419
Phone
(770) 712-4903
NPI assigned
Nov 16, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2016

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

Authorized official

Name
Ms. Isoken J Onaiwu
Title
Owner
Phone
(770) 712-4903

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X 033-02-028-1 GA Primary

Addresses

Primary practice location

576 Nickajack Rd SW
Mableton, GA 30126-1419

Mailing address

576 Nickajack Rd SW
Mableton, GA 30126-1419
Phone (770) 712-4903

Other identifiers 1

IdentifierTypeStateIssuer
003168137AMedicaidGA

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1479254400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1479254400000",
    "number": "1023550407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "576 NICKAJACK RD SW",
            "city": "MABLETON",
            "state": "GA",
            "postal_code": "301261419",
            "telephone_number": "770-712-4903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "576 NICKAJACK RD SW",
            "city": "MABLETON",
            "state": "GA",
            "postal_code": "301261419",
            "telephone_number": "770-712-4903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMELIA GARDENS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-11-16",
        "last_updated": "2016-11-16",
        "status": "A",
        "authorized_official_last_name": "ONAIWU",
        "authorized_official_first_name": "ISOKEN",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "770-712-4903",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "GA",
            "license": "033-02-028-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003168137A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mableton, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2016; 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.