McTwynn, Inc

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

PERMIT NO PCH009056 Issued in GA

Legal business name

MCTWYNN, INC

Doing business as

Lakeview Retirement Center

Practice address

111 Stephens Ave
Baxley, GA 31513

Phone

(912) 367-9109

Fax

(912) 367-5927

NPI assigned

May 5, 2014

Last updated

May 5, 2014By 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

Mrs. Kimberly Jenkins Wynn

Title

V.P./Sec

Phone

(912) 367-9109

Specialties & licenses 1

Addresses

Other names 1

• Lakeview Retirement Center Doing business as

Locations

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

{
    "created_epoch": "1399248000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1399248000000",
    "number": "1083024608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "426 E. PARKER ST",
            "city": "BAXLEY",
            "state": "GA",
            "postal_code": "31513",
            "telephone_number": "912-367-9109",
            "fax_number": "912-367-5927"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 STEPHENS AVE",
            "city": "BAXLEY",
            "state": "GA",
            "postal_code": "31513",
            "telephone_number": "912-367-9109",
            "fax_number": "912-367-5927"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MCTWYNN, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-05-05",
        "last_updated": "2014-05-05",
        "status": "A",
        "authorized_official_last_name": "WYNN",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_middle_name": "JENKINS",
        "authorized_official_title_or_position": "V.P./SEC",
        "authorized_official_telephone_number": "912-367-9109",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "GA",
            "license": "PERMIT NO PCH009056",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lakeview Retirement Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jonathan Cade McCullar
• Myiesha Sellers McFarlin, NP
• Jan S McKay, DC
• Mary Kathryn McMahan, MD
• Patricia Dale McTier, RN
• Marley Mikell Melton, OTR/L
• Heather Strickland Miller, PA-C
• Kimberly Dawn Mitcham, FNP
• Gerry Delayne Moore Sr.
• Crystal Nicole Moran

• Assisted Living Facility in Baxley, GA
• Providers in Baxley, GA by specialty
• Assisted Living Facility in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2014; 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.