NPIMap

Organization Active NPI

Great Day Personal Care LLC

Doing business as Great Day Personal Care Home 11

  • Assisted Living Facility
  • Augusta, GA
National Provider Identifier
1245981430
Registry record updated Jan 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
Legal business name
GREAT DAY PERSONAL CARE LLC
Doing business as
Great Day Personal Care Home 11
Practice address
2059 Clark St
Augusta, GA 30904-3067
Phone
(706) 836-0979
NPI assigned
Jan 10, 2022
Last updated
Jan 10, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2022

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

Authorized official

Name
Mrs. Nicole Dernell CooperNPI 1346915907
Title
Owner
Phone
(706) 836-0979

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X Primary

Addresses

Primary practice location

2059 Clark St
Augusta, GA 30904-3067

Mailing address

2059 Clark St
Augusta, GA 30904-3067
Phone (706) 836-0979

Other identifiers 2

IdentifierTypeStateIssuer
003256240AMedicaidGA
003256240BMedicaidGA

Other names 1

  • Great Day Personal Care Home 11 Doing business as

National Provider Directory

National Provider Directory

Locations

2059 Clark St
Augusta, GA 30904
Phone (706) 836-0979

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": "1641772800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1641772800000",
    "number": "1245981430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2059 CLARK ST",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309043067",
            "telephone_number": "706-836-0979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2059 CLARK ST",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309043067",
            "telephone_number": "706-836-0979"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREAT DAY PERSONAL CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-10",
        "last_updated": "2022-01-10",
        "certification_date": "2022-01-10",
        "status": "A",
        "authorized_official_last_name": "COOPER",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_middle_name": "DERNELL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "706-836-0979",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003256240A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003256240B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Great Day Personal Care Home 11",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Augusta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2022; 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.