NPIMap

Organization Active NPI

Blackshear Retirement Villa Als

  • Skilled Nursing Facility
  • Cordele, GA
National Provider Identifier
1194993634
Registry record updated Feb 19, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
040446 Issued in GA
Legal business name
BLACKSHEAR RETIREMENT VILLA ALS
Practice address
902 Blackshear Rd
Cordele, GA 31015-3665
Phone
(229) 271-9686
Fax
(229) 271-9689
NPI assigned
Feb 19, 2008
Last updated
Feb 19, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2008

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

Authorized official

Name
Mrs. Amanda Bridges Saratsiotis
Title
Patient Accounting Director
Phone
(229) 271-9686

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 040446 GA Primary

Addresses

Primary practice location

902 Blackshear Rd
Cordele, GA 31015-3665

Mailing address

902 Blackshear Rd
Cordele, GA 31015-3665
Phone (229) 271-9686

National Provider Directory

National Provider Directory
Tax ID family
Surgical Associates22 organizations share this tax ID, including this one

Other organizations with this tax ID 21

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

View all 21

NPI Registry JSON

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

{
    "created_epoch": "1203379200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1203379200000",
    "number": "1194993634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "902 BLACKSHEAR RD",
            "city": "CORDELE",
            "state": "GA",
            "postal_code": "310153665",
            "telephone_number": "229-271-9686",
            "fax_number": "229-271-9689"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "902 BLACKSHEAR RD",
            "city": "CORDELE",
            "state": "GA",
            "postal_code": "310153665",
            "telephone_number": "229-271-9686",
            "fax_number": "229-271-9689"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLACKSHEAR RETIREMENT VILLA ALS",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-19",
        "last_updated": "2008-02-19",
        "status": "A",
        "authorized_official_last_name": "SARATSIOTIS",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_middle_name": "BRIDGES",
        "authorized_official_title_or_position": "PATIENT ACCOUNTING DIRECTOR",
        "authorized_official_telephone_number": "229-271-9686",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "GA",
            "license": "040446",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cordele, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 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.