Active NPI
Shriver Management Group Inc
- Adult Care Home Facility
- Perry, GA
National Provider Identifier
1326713256
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Care Home Facility
- Legal business name
- SHRIVER MANAGEMENT GROUP INC
- Practice address
- 1026 Keith Dr
Perry, GA 31069-2947 - Phone
- (478) 987-2535
- NPI assigned
- Aug 12, 2021
- Organization subpart
- Yes
- Parent organization
- SHRIVER MANAGEMENT GROUP INC
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Michael Shane Shriver
- Title
- President
- Phone
- (404) 273-2361
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Care Home Facility | 311ZA0620X | Primary |
Addresses
Primary practice location
1026 Keith Dr
Perry, GA 31069-2947
Mailing address
PO Box 1405
Dublin, GA 31040-1405
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 911542310C | Medicaid | GA | |
| 911542310H | Medicaid | GA |
Other names 1
- AUTUMN TERRACE #2
National Provider Directory
National Provider Directory- Tax ID family
- Shriver Management Group Inc
- Part of
- Shriver Management Group Inc
Other organizations with this tax ID 2
Organizations that report the same tax identification number in the National Provider Directory.
-
- Adult Care Home Facility
- Dublin, GA
- NPI 1396410239
-
- Adult Care Home Facility
- Perry, GA
- NPI 1396413027
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1628726400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1628726400000",
"number": "1326713256",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1405",
"city": "DUBLIN",
"state": "GA",
"postal_code": "310401405"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1026 KEITH DR",
"city": "PERRY",
"state": "GA",
"postal_code": "310692947",
"telephone_number": "478-987-2535"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SHRIVER MANAGEMENT GROUP INC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "SHRIVER MANAGEMENT GROUP INC",
"enumeration_date": "2021-08-12",
"last_updated": "2021-08-12",
"certification_date": "2021-08-12",
"status": "A",
"authorized_official_last_name": "SHRIVER",
"authorized_official_first_name": "MICHAEL",
"authorized_official_middle_name": "SHANE",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "404-273-2361"
},
"taxonomies": [
{
"code": "311ZA0620X",
"taxonomy_group": "",
"desc": "Custodial Care Facility, Adult Care Home",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "911542310C",
"state": "GA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "911542310H",
"state": "GA"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "AUTUMN TERRACE #2",
"code": "5",
"type": "Other Name"
}
]
}
Other providers in Perry, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.