Mt Berry Hospice Inc.

Primary specialty

Inpatient HospiceTaxonomy code 315D00000X

License

036-0347-H Issued in GA

Legal business name

MT BERRY HOSPICE INC.

Practice address

4300 Martha Berry Hwy NE
Rome, GA 30165-8642

Phone

(706) 232-1571

Fax

(706) 232-1572

NPI assigned

Nov 26, 2013

Organization subpart

No

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

Authorized official

Name

George West

Title

Cfo

Phone

(770) 907-7222

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1385424000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1385424000000",
    "number": "1306276498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4300 MARTHA BERRY HWY NE",
            "city": "ROME",
            "state": "GA",
            "postal_code": "301658642",
            "telephone_number": "706-232-1571",
            "fax_number": "706-232-1572"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4300 MARTHA BERRY HWY NE",
            "city": "ROME",
            "state": "GA",
            "postal_code": "301658642",
            "telephone_number": "706-232-1571",
            "fax_number": "706-232-1572"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MT BERRY HOSPICE INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-11-26",
        "last_updated": "2013-11-26",
        "status": "A",
        "authorized_official_last_name": "WEST",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "770-907-7222"
    },
    "taxonomies": [
        {
            "code": "315D00000X",
            "taxonomy_group": "",
            "desc": "Hospice, Inpatient",
            "state": "GA",
            "license": "036-0347-H",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "11-1714",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Scarlett Ashleigh Prince Mosley, MS
• Susan Leslie Mosley, LAC
• Patrick Grant Moss, CRNA
• Seaborn Thomas Moss, M.D.
• Thomas Hudson Moss IV, DPT
• Katherine Michelle Mueller, APRN, BC
• Sobia Mujtaba, M.D., MPH
• Richard L Muller Jr., DDS
• Thomas W Muller, M.D.
• Camala Mullins, CCC-SLP

• Inpatient Hospice in Rome, GA
• Providers in Rome, GA by specialty
• Inpatient Hospice in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2013; 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.