Wickshire Buford Opco LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

WICKSHIRE BUFORD OPCO LLC

Practice address

4355 South Lee Street
Buford, GA 30518

Phone

(770) 271-0277

Fax

(770) 221-2809

NPI assigned

Jan 2, 2020

Organization subpart

No

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

Authorized official

Name

Mr. Daniel Okeefe, JD

Title

Ceo

Phone

(615) 942-0240

Specialties & licenses 1

Addresses

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

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

{
    "created_epoch": "1577923200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1577923200000",
    "number": "1295374684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "750 OLD HICKORY BLVD",
            "address_2": "BUILDING ONE SUITE 125",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "37027",
            "telephone_number": "615-942-0240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4355 SOUTH LEE STREET",
            "city": "BUFORD",
            "state": "GA",
            "postal_code": "30518",
            "telephone_number": "770-271-0277",
            "fax_number": "770-221-2809"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WICKSHIRE BUFORD OPCO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-02",
        "last_updated": "2020-01-02",
        "certification_date": "2020-01-02",
        "status": "A",
        "authorized_official_last_name": "OKEEFE",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "615-942-0240",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "JD"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Leigh Regine Westergren, LCSW
• Hannah Lee Wheeler, PA-C
• Emily White, PH.D., BCBA-D
• Gloria White
• Damali Abenaa Whitfield, OTR/L
• Emma Nicole Wilbanks
• Teairah Wilbert
• Stefanie Lee Willard, OTRL
• Crystal Williams, RN
• Jasmine Sherrell Williams, FNP-BC

• Assisted Living Facility in Buford, GA
• Providers in Buford, GA by specialty
• Assisted Living Facility in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.