Ft Gaines Healthcare LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

FT GAINES HEALTHCARE LLC

Doing business as

Ft. Gaines Healthcare

Practice address

101 Hartford Rd
Fort Gaines, GA 39851-3639

Phone

(229) 768-2521

Fax

(229) 768-2466

NPI assigned

May 31, 2005

Last updated

Sep 29, 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

Tygh Brogdon

Title

Manager

Phone

(770) 650-8773

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Ft. Gaines Healthcare Doing business as

Tax ID family

Fort Gaines Health and Rehab2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Fort Gaines Operator LLC

  dba Fort Gaines Health and Rehab

  • Skilled Nursing Facility
  • Fort Gaines, GA
  • NPI 1750553996
  NPD tax ID

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

{
    "created_epoch": "1117497600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1222646400000",
    "number": "1124021506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 HARTFORD RD",
            "city": "FORT GAINES",
            "state": "GA",
            "postal_code": "398513639",
            "telephone_number": "229-768-2521",
            "fax_number": "229-768-2466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 HARTFORD RD",
            "city": "FORT GAINES",
            "state": "GA",
            "postal_code": "398513639",
            "telephone_number": "229-768-2521",
            "fax_number": "229-768-2466"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FT GAINES HEALTHCARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-05-31",
        "last_updated": "2008-09-29",
        "status": "A",
        "authorized_official_last_name": "BROGDON",
        "authorized_official_first_name": "TYGH",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "770-650-8773"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "GA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00140599A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ft. Gaines Healthcare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jessica Michelle Collins, APRN
• Cricket Drugs, Inc
• Cricket Drugs, Inc
• Joseph Kizito Egbebike, PHD.,PT
• Fort Gaines Operator LLC (Fort Gaines Health and Rehab)
• Ft Gaines Medical Associates PC
• Karen Sue Kinsell, M.D.
• Heather McRee Reynolds, PHARM D
• Jennifer Sanders, PA-C
• Cynthia L Sumner, MD

• Skilled Nursing Facility in Fort Gaines, GA
• Providers in Fort Gaines, GA by specialty
• Skilled Nursing Facility in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 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.