Delta Health Group Inc

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

10483 Issued in AL

Legal business name

DELTA HEALTH GROUP INC

Doing business as

Willow Trace Nursing Center

Practice address

1406 E Pushmataha St
Butler, AL 36904-2728

Phone

(205) 459-5506

Fax

(205) 459-5503

NPI assigned

Aug 17, 2005

Last updated

Aug 6, 2009By 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

Scott J Bell

Title

Ceo President

Phone

(850) 430-0000

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Willow Trace Nursing Center Doing business as

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

{
    "created_epoch": "1124236800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1249516800000",
    "number": "1285626150",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 N PALAFOX ST",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325025631",
            "telephone_number": "850-430-0000",
            "fax_number": "850-436-6766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1406 E PUSHMATAHA ST",
            "city": "BUTLER",
            "state": "AL",
            "postal_code": "369042728",
            "telephone_number": "205-459-5506",
            "fax_number": "205-459-5503"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DELTA HEALTH GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-17",
        "last_updated": "2009-08-06",
        "status": "A",
        "authorized_official_last_name": "BELL",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CEO PRESIDENT",
        "authorized_official_telephone_number": "850-430-0000"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "AL",
            "license": "10483",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "47-51060S",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Willow Trace Nursing Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Skilled Nursing Facility in Butler, AL
• Providers in Butler, AL by specialty
• Skilled Nursing Facility in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2009; 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.