Trinity Healthcare

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

RN194174 Issued in GA

Legal business name

TRINITY HEALTHCARE

Practice address

154 S Leroy St
Metter, GA 30439-4631

Phone

(912) 713-1007

Fax

(912) 450-0998

NPI assigned

Jan 27, 2017

Organization subpart

No

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

Authorized official

Name

Jacqueline Brown, FNP

Title

Partner

Phone

(912) 713-1007

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1485475200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1488844800000",
    "number": "1336686336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "154 S LEROY ST",
            "city": "METTER",
            "state": "GA",
            "postal_code": "304394631",
            "telephone_number": "912-685-2246",
            "fax_number": "912-685-2248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "154 S LEROY ST",
            "city": "METTER",
            "state": "GA",
            "postal_code": "304394631",
            "telephone_number": "912-713-1007",
            "fax_number": "912-450-0998"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRINITY HEALTHCARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-27",
        "last_updated": "2017-03-07",
        "status": "A",
        "authorized_official_last_name": "BROWN",
        "authorized_official_first_name": "JACQUELINE",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "912-713-1007",
        "authorized_official_credential": "FNP"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "GA",
            "license": "RN194174",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bobby Dean Stone Jr., R.PH., CDM
• Krista Lynn Stone, RPH
• Timothy Jay Strickland, M.ED., LPC, MAC,CCS
• Tattnall Hospital Company, LLC (Optim Primary Care Metter)
• Hannah Price Todd, FNP
• Teresa Etim Udowana, RPH
• Tameria Vereen
• Walgreen Co (Walgreens #17222)
• Shenique Anderson Wesley, M.D.
• Joshua James Wickstrom, MD

• Clinic/Center in Metter, GA
• Providers in Metter, GA by specialty
• Clinic/Center in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2017; 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.