NPIMap

Organization Active NPI

William C Byrd Inc

  • Assisted Living Facility
  • Moultrie, GA
National Provider Identifier
1053489252
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
Legal business name
WILLIAM C BYRD INC
Practice address
498 5TH Street SE
Moultrie, GA 31768
Phone
(229) 891-3336
Fax
(229) 891-3348
NPI assigned
Dec 4, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. William C Byrd
Title
Owner President
Phone
(229) 382-8655

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X GA Primary

Addresses

Primary practice location

498 5TH Street SE
Moultrie, GA 31768

Mailing address

PO Box 890
Tifton, GA 31793
Phone (229) 382-8655

Other identifiers 1

IdentifierTypeStateIssuer
00905066AMedicaidGA

Other names 1

  • Colquitt Garden Manor Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Bradley Place6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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

Locations

498 5th St SE
Moultrie, GA 31768
Phone (229) 891-3336

NPI Registry JSON

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

{
    "created_epoch": "1165190400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1053489252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 890",
            "city": "TIFTON",
            "state": "GA",
            "postal_code": "31793",
            "telephone_number": "229-382-8655",
            "fax_number": "229-382-7011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "498 5TH STREET SE",
            "city": "MOULTRIE",
            "state": "GA",
            "postal_code": "31768",
            "telephone_number": "229-891-3336",
            "fax_number": "229-891-3348"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLIAM C BYRD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-04",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BYRD",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OWNER PRESIDENT",
        "authorized_official_telephone_number": "229-382-8655",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "GA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00905066A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Colquitt Garden Manor",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Moultrie, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.