NPIMap

Organization Active NPI

Peach State Nursing Agency

  • Home Health Agency
  • Milledgeville, GA
National Provider Identifier
1326119710
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
005-R-0003 Issued in GA
Legal business name
PEACH STATE NURSING AGENCY
Practice address
140 W Washington St
Milledgeville, GA 31061-3434
Phone
(478) 453-3369
Fax
(478) 453-1131
NPI assigned
Nov 10, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Ms. Robin Long
Title
President
Phone
(478) 453-3369

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X 005-R-0003 GA Primary

Addresses

Primary practice location

140 W Washington St
Milledgeville, GA 31061-3434

Mailing address

PO Box 326
140 West Washington St.
Milledgeville, GA 31059-0326
Phone (478) 453-3369

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1163116800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1326119710",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 326",
            "address_2": "140 WEST WASHINGTON ST.",
            "city": "MILLEDGEVILLE",
            "state": "GA",
            "postal_code": "310590326",
            "telephone_number": "478-453-3369",
            "fax_number": "478-453-1131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 W WASHINGTON ST",
            "city": "MILLEDGEVILLE",
            "state": "GA",
            "postal_code": "310613434",
            "telephone_number": "478-453-3369",
            "fax_number": "478-453-1131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEACH STATE NURSING AGENCY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-10",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "LONG",
        "authorized_official_first_name": "ROBIN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "478-453-3369",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "GA",
            "license": "005-R-0003",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milledgeville, GA

Sources for this page

  • 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.