NPIMap

Organization Active NPI

Shriver Management Group Inc

  • Adult Care Home Facility
  • Dublin, GA
National Provider Identifier
1396410239
Registry record updated Aug 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Care Home FacilityTaxonomy code 311ZA0620X
Legal business name
SHRIVER MANAGEMENT GROUP INC
Practice address
811 Bellevue Ave
Dublin, GA 31021-4847
Phone
(478) 353-1065
NPI assigned
Aug 12, 2021
Organization subpart
Yes
Parent organization
SHRIVER MANAGEMENT GROUP INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 12, 2021

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)CodeLicenseStatePrimary
Adult Care Home Facility 311ZA0620X Primary

Addresses

Primary practice location

811 Bellevue Ave
Dublin, GA 31021-4847

Mailing address

PO Box 1405
Dublin, GA 31040-1405

Other identifiers 2

IdentifierTypeStateIssuer
000359114BMedicaidGA
000359114AMedicaidGA

Other names 1

  • HERITAGE HOUSE Other name

National Provider Directory

National Provider Directory
Tax ID family
Shriver Management Group Inc3 organizations share this tax ID, including this one
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.

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": "1396410239",
    "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": "811 BELLEVUE AVE",
            "city": "DUBLIN",
            "state": "GA",
            "postal_code": "310214847",
            "telephone_number": "478-353-1065"
        }
    ],
    "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": "000359114B",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000359114A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "HERITAGE HOUSE",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Dublin, 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.

Verify at the official NPI Registry.