Immediate Care of Rome #1, LLC

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

RN113917 Issued in GA

Legal business name

IMMEDIATE CARE OF ROME #1, LLC

Practice address

18 Riverbend Dr SW
Suite 230
Rome, GA 30161-6013

Phone

(706) 291-2999

Fax

(706) 291-4006

NPI assigned

Feb 11, 2010

Last updated

Feb 11, 2010By 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 Wildmon

Title

Coo

Phone

(706) 354-1036

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1265846400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1265846400000",
    "number": "1144552423",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18 RIVERBEND DR SW",
            "address_2": "SUITE 230",
            "city": "ROME",
            "state": "GA",
            "postal_code": "301616013",
            "telephone_number": "706-291-2999",
            "fax_number": "706-291-4006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18 RIVERBEND DR SW",
            "address_2": "SUITE 230",
            "city": "ROME",
            "state": "GA",
            "postal_code": "301616013",
            "telephone_number": "706-291-2999",
            "fax_number": "706-291-4006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMMEDIATE CARE OF ROME #1, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-02-11",
        "last_updated": "2010-02-11",
        "status": "A",
        "authorized_official_last_name": "WILDMON",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "706-354-1036"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "RN113917",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Nurse Practitioner in Rome, GA
• Providers in Rome, GA by specialty
• Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2010; 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.