Genesis Healthcare

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

4126 Issued in MS

Legal business name

GENESIS HEALTHCARE

Practice address

2142 E Whitworth St
Hazlehurst, MS 39083-9277

Phone

(601) 278-8986

NPI assigned

Feb 12, 2016

Last updated

Feb 12, 2016By 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

Robert Bradley Woods, LPTA

Title

Physical Therapy Assistant

Phone

(601) 278-8986

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1455235200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1455235200000",
    "number": "1114386687",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2142 EAST WHITWORTH STREET",
            "city": "HAZLEHURST",
            "state": "MS",
            "postal_code": "39083",
            "telephone_number": "601-278-8986"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2142 E WHITWORTH ST",
            "city": "HAZLEHURST",
            "state": "MS",
            "postal_code": "390839277",
            "telephone_number": "601-278-8986"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENESIS HEALTHCARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-12",
        "last_updated": "2016-02-12",
        "status": "A",
        "authorized_official_last_name": "WOODS",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "BRADLEY",
        "authorized_official_title_or_position": "PHYSICAL THERAPY ASSISTANT",
        "authorized_official_telephone_number": "601-278-8986",
        "authorized_official_credential": "LPTA"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "MS",
            "license": "4126",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Skilled Nursing Facility in Hazlehurst, MS
• Providers in Hazlehurst, MS by specialty
• Skilled Nursing Facility in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 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.