Our Lady of the Roses Primary Care

Primary specialty

Migrant Health Clinic/CenterTaxonomy code 261QM1000X

License

RN042301 Issued in GA

Legal business name

OUR LADY OF THE ROSES PRIMARY CARE

Practice address

808 21St St
Columbus, GA 31904-8817

Phone

(706) 587-5771

NPI assigned

Oct 7, 2015

Last updated

Oct 7, 2015By 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

Mr. Gerald William Wieczorek

Title

Business Manager

Phone

(706) 327-4880

Specialties & licenses 1

Addresses

Other identifiers 2

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.

• Susan Carol Wieczorek, NP-C, CWOCN

  • Family Nurse Practitioner
  • Columbus, GA
  • NPI 1013087386
  NPD

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

{
    "created_epoch": "1444176000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1444176000000",
    "number": "1205207933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1957",
            "city": "FORTSON",
            "state": "GA",
            "postal_code": "318081957",
            "telephone_number": "706-587-5771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "808 21ST ST",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319048817",
            "telephone_number": "706-587-5771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OUR LADY OF THE ROSES PRIMARY CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-07",
        "last_updated": "2015-10-07",
        "status": "A",
        "authorized_official_last_name": "WIECZOREK",
        "authorized_official_first_name": "GERALD",
        "authorized_official_middle_name": "WILLIAM",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "706-327-4880",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QM1000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Migrant Health",
            "state": "GA",
            "license": "RN042301",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000901106D",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "126693",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ossp Imaging of Columbus
• Daniel Ostermann II, BME
• Kristen B Osterrieder, PA-C
• Nicole Susan Oswalt
• Natouri Ottun, PHARM.D., BCPS
• Our Lady of the Roses Primary Care
• Our Voice Matters LLC
• Outback Care Group
• Aniya Outley, RBT
• Delta Joyce Outley, MASTERS

• Clinic/Center in Columbus, GA
• Providers in Columbus, GA by specialty
• Clinic/Center in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2015; 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.