NPIMap

Organization Active NPI

Made Whole Healthcare Solutions, Inc

  • Primary Care Clinic/Center
  • Albany, GA
National Provider Identifier
1134519077
Registry record updated Jul 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
RN131505 Issued in GA
Legal business name
MADE WHOLE HEALTHCARE SOLUTIONS, INC
Practice address
2709 Gillionville Rd
Albany, GA 31721-6271
Phone
(229) 483-0020
Fax
(229) 483-0021
NPI assigned
Jan 30, 2015
Last updated
Jul 10, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2019

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

Authorized official

Name
Nedra S Fortson, APRNNPI 1568804987
Title
Nurse Practitioner
Phone
(770) 330-8496

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X RN131505 GA Primary
Adult Health Nurse Practitioner 363LA2200X NU

Addresses

Primary practice location

2709 Gillionville Rd
Albany, GA 31721-6271

Mailing address

PO Box 71802
Albany, GA 31708-1802
Phone (770) 330-8496

Other identifiers 2

IdentifierTypeStateIssuer
20250I9514OtherGAMEDICARE PTAN
217951MedicaidGA

National Provider Directory

National Provider Directory

Locations

2709 Gillionville Rd
Albany, GA 31721
Phone (229) 483-0020

2709 Gillionville Rd
Ste 1
Albany, GA 31721
Phone (229) 483-0020

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1422576000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1562716800000",
    "number": "1134519077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 71802",
            "city": "ALBANY",
            "state": "GA",
            "postal_code": "317081802",
            "telephone_number": "770-330-8496",
            "fax_number": "229-888-7421"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2709 GILLIONVILLE RD",
            "city": "ALBANY",
            "state": "GA",
            "postal_code": "317216271",
            "telephone_number": "229-483-0020",
            "fax_number": "229-483-0021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MADE WHOLE HEALTHCARE SOLUTIONS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-30",
        "last_updated": "2019-07-10",
        "status": "A",
        "authorized_official_last_name": "FORTSON",
        "authorized_official_first_name": "NEDRA",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "NURSE PRACTITIONER",
        "authorized_official_telephone_number": "770-330-8496",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "GA",
            "license": "RN131505",
            "primary": true
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "20250I9514",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "217951",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Albany, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2019; 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.