Richmond Nursing Home Inc

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

RICHMOND NURSING HOME INC

Doing business as

West Lake Manor Health Care Center

Practice address

820 Stevens Creek Rd
Augusta, GA 30907-9251

Phone

(706) 860-6622

Fax

(706) 860-6532

NPI assigned

Jul 29, 2005

Last updated

Aug 22, 2020By 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. Thomas W Penley Sr.

Title

Ceo

Phone

(706) 855-1773

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• West Lake Manor Health Care Center Doing business as

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

{
    "created_epoch": "1122595200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1285634220",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "820 STEVENS CREEK RD",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309079251",
            "telephone_number": "706-860-6622",
            "fax_number": "706-860-6532"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "820 STEVENS CREEK RD",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309079251",
            "telephone_number": "706-860-6622",
            "fax_number": "706-860-6532"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RICHMOND NURSING HOME INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-29",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PENLEY",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "706-855-1773",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Sr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00213463A",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DME",
            "identifier": "1062280001",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "West Lake Manor Health Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Shirlee Ann Richardson, RN
• Richmond County Board of Health (Richmond County Health Department)
• Richmond County Board of Health (RICHMOND COUNTY HEALTH DEPARTMENT South Augusta Clinic)
• Richmond County Boe
• Richmond County Health Dept.
• Lanette Rickborn, MD
• Bailey Michelle Rickett, PA
• Michael Everett Ridlehoover, DMD
• Alexandria Riedel, MD
• Katie Riegelman, DPT

• Skilled Nursing Facility in Augusta, GA
• Providers in Augusta, GA by specialty
• Skilled Nursing Facility in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.