NPIMap

Organization Active NPI

Restoration Healthcare of Commerce, LLC

  • Nursing Facility/Intermediate Care Facility
  • Commerce, GA
National Provider Identifier
1376860403
Registry record updated Apr 29, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nursing Facility/Intermediate Care FacilityTaxonomy code 313M00000X
License
1-078-0292 Issued in GA
Legal business name
RESTORATION HEALTHCARE OF COMMERCE, LLC
Practice address
70 Medical Center Dr
Commerce, GA 30529-1078
Phone
(706) 335-1000
Fax
(706) 335-7701
NPI assigned
Apr 29, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2010

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

Authorized official

Name
Mr. Stephen N Clapp
Title
President
Phone
(865) 607-9923

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nursing Facility/Intermediate Care Facility 313M00000X 1-078-0292 GA Primary
Skilled Nursing Facility 314000000X 1-078-0292 GA

Addresses

Primary practice location

70 Medical Center Dr
Commerce, GA 30529-1078

Mailing address

70 Medical Center Dr
Commerce, GA 30529-1078
Phone (706) 335-1000

Other identifiers 1

IdentifierTypeStateIssuer
000059331AMedicaidGA

Other names 1

  • BJC Nursing Home Doing business as

National Provider Directory

National Provider Directory
Tax ID family
BJC Medical Center3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1272499200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1272499200000",
    "number": "1376860403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "70 MEDICAL CENTER DR",
            "city": "COMMERCE",
            "state": "GA",
            "postal_code": "305291078",
            "telephone_number": "706-335-1000",
            "fax_number": "706-335-7701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "70 MEDICAL CENTER DR",
            "city": "COMMERCE",
            "state": "GA",
            "postal_code": "305291078",
            "telephone_number": "706-335-1000",
            "fax_number": "706-335-7701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RESTORATION HEALTHCARE OF COMMERCE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-04-29",
        "last_updated": "2010-04-29",
        "status": "A",
        "authorized_official_last_name": "CLAPP",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "865-607-9923",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": "GA",
            "license": "1-078-0292",
            "primary": true
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "GA",
            "license": "1-078-0292",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000059331A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BJC Nursing Home",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Commerce, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2010; 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.