Organization Active NPI

Iris Cove Personal Care Home LLC

  • Assisted Living Facility
  • Augusta, GA
National Provider Identifier
1255917381
Registry record updated May 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
Legal business name
IRIS COVE PERSONAL CARE HOME LLC
Practice address
2382 Wheeless Rd
Augusta, GA 30906-5404
Phone
(706) 306-0273
NPI assigned
Mar 19, 2021
Last updated
May 18, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 18, 2021

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

Authorized official

Name
Mrs. Nicole Eubanks BentleyNPI 1962829234
Title
Owner
Phone
(706) 306-0273

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 NU Primary

Addresses

Primary practice location

2382 Wheeless Rd
Augusta, GA 30906-5404

Mailing address

2382 Wheeless Rd
Augusta, GA 30906-5404
Phone (706) 306-0273

National Provider Directory

National Provider Directory

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": "1616112000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1621296000000",
    "number": "1255917381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2382 WHEELESS RD",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309065404",
            "telephone_number": "706-306-0273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2382 WHEELESS RD",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309065404",
            "telephone_number": "706-306-0273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IRIS COVE PERSONAL CARE HOME LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-19",
        "last_updated": "2021-05-18",
        "certification_date": "2021-05-18",
        "status": "A",
        "authorized_official_last_name": "BENTLEY",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_middle_name": "EUBANKS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "706-306-0273",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 May 18, 2021; 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.