Elks Aidmore, Inc.

Primary specialty

Foster Care AgencyTaxonomy code 253J00000X

License

C1000Q010056 Issued in GA

Legal business name

ELKS AIDMORE, INC.

Practice address

2394 Morrison Rd SW
Conyers, GA 30094-3330

Phone

(770) 483-3535

Fax

(770) 483-5696

NPI assigned

Jun 8, 2012

Organization subpart

No

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

Authorized official

Name

Mr. Abe Meyer Wilkinson

Title

Ceo

Phone

(770) 483-3535

Specialties & licenses 1

Addresses

Other names 1

• Elks Aidmore Children's Center Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kendra Witherspoon, LPC

  • Professional Counselor
  • Atlanta, GA
  • NPI 1093229643
  NPD (past)

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

{
    "created_epoch": "1339113600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1339113600000",
    "number": "1316209083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2394 MORRISON RD SW",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300943330",
            "telephone_number": "770-483-3535",
            "fax_number": "770-483-5696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2394 MORRISON RD SW",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300943330",
            "telephone_number": "770-483-3535",
            "fax_number": "770-483-5696"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELKS AIDMORE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-08",
        "last_updated": "2012-06-08",
        "status": "A",
        "authorized_official_last_name": "WILKINSON",
        "authorized_official_first_name": "ABE",
        "authorized_official_middle_name": "MEYER",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "770-483-3535",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "253J00000X",
            "taxonomy_group": "",
            "desc": "Foster Care Agency",
            "state": "GA",
            "license": "C1000Q010056",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Elks Aidmore Children's Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• John Jerome Ekong, MD
• Mohamad El-Attar, M.D.
• Tia Marie Eley
• Elite Surgical Assisting LLC
• Bernard Peter Elkon, LPC
• Ellen Paige Montgomery, LLC
• Caroline Ellis
• Selina Y Ellis
• Sherenda Lashawn Ellis
• Howard Steven Ellison, MD

• Foster Care Agency in Conyers, GA
• Providers in Conyers, GA by specialty
• Foster Care Agency in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2012; 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.