South Dooley Retirement Center

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

Legal business name

SOUTH DOOLEY RETIREMENT CENTER

Practice address

105 S Dooley St
105 South Dooley Street
Hawkinsville, GA 31036-1703

Phone

(478) 783-4117

NPI assigned

Jul 17, 2008

Last updated

Jul 17, 2008By 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. Doris Ellis Kelley, M.S.

Title

Administrator

Phone

(478) 783-4117

Specialties & licenses 1

Addresses

Other identifiers 2

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

{
    "created_epoch": "1216252800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1216252800000",
    "number": "1114181161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 SOUTH DOOLEY STREET",
            "city": "HAWKINSVILLE",
            "state": "GA",
            "postal_code": "31036",
            "telephone_number": "478-783-4117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 S DOOLEY ST",
            "address_2": "105 SOUTH DOOLEY STREET",
            "city": "HAWKINSVILLE",
            "state": "GA",
            "postal_code": "310361703",
            "telephone_number": "478-783-4117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH DOOLEY RETIREMENT CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-17",
        "last_updated": "2008-07-17",
        "status": "A",
        "authorized_official_last_name": "KELLEY",
        "authorized_official_first_name": "DORIS",
        "authorized_official_middle_name": "ELLIS",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "478-783-4117",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "M.S."
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "GA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "968169651B",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "968169651A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Monte D Slater, MD
• James C Smith, NP
• Joseph Franklin Smith, MA,LPC
• Mindy Smith, LMSW
• Source Care Management LLC
• Southern Bridge Counseling, LLC
• Southern Hills Inpatient Services LLC
• Southern Pines Retirement Villa
• Southland Hawkinsville Emergency Medical Services, LLC
• Southland Taylor Hospitalist Group, LLC

• Community Based Hospice Care Agency in Hawkinsville, GA
• Providers in Hawkinsville, GA by specialty
• Community Based Hospice Care Agency in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2008; 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.