Brentwood Nursing LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

10211656 Issued in GA

Legal business name

BRENTWOOD NURSING LLC

Doing business as

Pleasant View Nursing Center

Practice address

475 Washington St
Metter, GA 30439-3809

Phone

(912) 685-2168

Fax

(912) 685-3939

NPI assigned

Apr 19, 2006

Last updated

Sep 29, 2008By 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

Tygh Brogdon

Title

Manager

Phone

(770) 650-8773

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Pleasant View Nursing Center Doing business as

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

{
    "created_epoch": "1145404800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1222646400000",
    "number": "1295790681",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1145 HEMBREE RD",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300761122",
            "telephone_number": "770-650-8773",
            "fax_number": "770-650-9732"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "475 WASHINGTON ST",
            "city": "METTER",
            "state": "GA",
            "postal_code": "304393809",
            "telephone_number": "912-685-2168",
            "fax_number": "912-685-3939"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRENTWOOD NURSING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-19",
        "last_updated": "2008-09-29",
        "status": "A",
        "authorized_official_last_name": "BROGDON",
        "authorized_official_first_name": "TYGH",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "770-650-8773"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "GA",
            "license": "10211656",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000142546A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pleasant View Nursing Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Skilled Nursing Facility in Metter, GA
• Providers in Metter, 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 Sep 29, 2008; 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.