Avante at Waynesboro, Inc.

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

NH2492 Issued in VA

Legal business name

AVANTE AT WAYNESBORO, INC.

Practice address

1221 Rosser Ave
Waynesboro, VA 22980-3336

Phone

(540) 949-7191

Fax

(540) 943-1738

NPI assigned

Oct 23, 2006

Organization subpart

No

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

Authorized official

Name

Ms. Lisa Wilson

Title

President

Phone

(954) 987-7180

Specialties & licenses 1

Addresses

Other identifiers 2

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

{
    "created_epoch": "1161561600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1479081600000",
    "number": "1215010277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4601 SHERIDAN STREET",
            "address_2": "SUITE 500",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330213439",
            "telephone_number": "540-949-7191",
            "fax_number": "540-943-1738"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1221 ROSSER AVE",
            "city": "WAYNESBORO",
            "state": "VA",
            "postal_code": "229803336",
            "telephone_number": "540-949-7191",
            "fax_number": "540-943-1738"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AVANTE AT WAYNESBORO, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-23",
        "last_updated": "2016-11-14",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "LISA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "954-987-7180",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "VA",
            "license": "NH2492",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4951476",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4960181",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• All providers in Waynesboro, VA
• Skilled Nursing Facility in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2016; 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.