Wildwood Health Care, Inc.

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

1-112-1344 Issued in GA

Legal business name

WILDWOOD HEALTH CARE, INC.

Practice address

184 Pinhook Rd
Talking Rock, GA 30175-3495

Phone

(706) 692-6014

Fax

(706) 692-6695

NPI assigned

Sep 29, 2005

Organization subpart

No

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

Authorized official

Name

Mr. Dee F. Wilbanks

Title

Administrator/Owner

Phone

(706) 692-6014

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1127952000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1336136019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "184 PINHOOK RD",
            "city": "TALKING ROCK",
            "state": "GA",
            "postal_code": "301753495",
            "telephone_number": "706-692-6014",
            "fax_number": "706-692-6695"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "184 PINHOOK RD",
            "city": "TALKING ROCK",
            "state": "GA",
            "postal_code": "301753495",
            "telephone_number": "706-692-6014",
            "fax_number": "706-692-6695"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILDWOOD HEALTH CARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-29",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WILBANKS",
        "authorized_official_first_name": "DEE",
        "authorized_official_middle_name": "F.",
        "authorized_official_title_or_position": "ADMINISTRATOR/OWNER",
        "authorized_official_telephone_number": "706-692-6014",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "GA",
            "license": "1-112-1344",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00143547A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• All providers in Talking Rock, GA
• Skilled Nursing Facility in Georgia

• 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.