NPIMap

Organization Active NPI

Heavenly Sunshine Health

  • Nurse's Aide
  • Athens, GA
National Provider Identifier
1396173159
Registry record updated Oct 14, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse's AideTaxonomy code 376K00000X
License
109-R-0323 Issued in GA
Legal business name
HEAVENLY SUNSHINE HEALTH
Practice address
975 Gaines School Rd # Build-4
Athens, GA 30605-3133
Phone
(706) 549-2289
Fax
(706) 549-1177
NPI assigned
Oct 14, 2013
Last updated
Oct 14, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2013

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

Authorized official

Name
Ms. Sabina GreshamNPI 1124366992
Title
Director/Owner
Phone
(706) 549-2289

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nursing Care Agency 251J00000X 109-R-0323 GA
Nurse's AideGroup: 193400000X SINGLE SPECIALTY GROUP 376K00000X 109-R-0323 GA Primary

Addresses

Primary practice location

975 Gaines School Rd # Build-4
Athens, GA 30605-3133

Mailing address

975 Gaines School Rd # Build-4
Athens, GA 30605-3133

Other identifiers 5

IdentifierTypeStateIssuer
896062924BMedicaidGA
896062924DMedicaidGA
896062924EMedicaidGA
896062924AMedicaidGA
003132295AMedicaidGA

National Provider Directory

National Provider Directory

Locations

975 Gaines School Rd
#4
Athens, GA 30605
Phone (706) 549-2289

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1381708800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1381708800000",
    "number": "1396173159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "975 GAINES SCHOOL RD # BUILD-4",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "306053133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "975 GAINES SCHOOL RD # BUILD-4",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "306053133",
            "telephone_number": "706-549-2289",
            "fax_number": "706-549-1177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEAVENLY SUNSHINE HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-10-14",
        "last_updated": "2013-10-14",
        "status": "A",
        "authorized_official_last_name": "GRESHAM",
        "authorized_official_first_name": "SABINA",
        "authorized_official_title_or_position": "DIRECTOR/OWNER",
        "authorized_official_telephone_number": "706-549-2289",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "251J00000X",
            "taxonomy_group": "",
            "desc": "Nursing Care",
            "state": "GA",
            "license": "109-R-0323",
            "primary": false
        },
        {
            "code": "376K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse's Aide",
            "state": "GA",
            "license": "109-R-0323",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "896062924B",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "896062924D",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "896062924E",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "896062924A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003132295A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Athens, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2013; 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.