NPIMap

Organization Active NPI

West Georgia Medical Center, Inc.

Doing business as Twin Fountains Home

  • Skilled Nursing Facility
  • Lagrange, GA
National Provider Identifier
1467685784
Registry record updated Feb 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
WEST GEORGIA MEDICAL CENTER, INC.
Doing business as
Twin Fountains Home
Practice address
1400 Hogansville Rd
Lagrange, GA 30241-1422
Phone
(706) 882-0121
Fax
(706) 882-0123
NPI assigned
Sep 3, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2020

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

Authorized official

Name
Mr. Anthony J Budzinski
Title
Evp
Phone
(470) 644-0012

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

1400 Hogansville Rd
Lagrange, GA 30241-1422

Mailing address

1800 Parkway PL SE Ste 500
Marietta, GA 30067-8237
Phone (470) 956-4981

Other identifiers 1

IdentifierTypeStateIssuer
00142843AMedicaidGA

Other names 1

  • Twin Fountains Home Doing business as

National Provider Directory

National Provider Directory

Locations

1640 Powers Ferry Rd SE
Bldg 15
Marietta, GA 30067
Phone (770) 722-9595

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1251936000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1582502400000",
    "number": "1467685784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 PARKWAY PL SE STE 500",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300678237",
            "telephone_number": "470-956-4981",
            "fax_number": "770-999-8237"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 HOGANSVILLE RD",
            "city": "LAGRANGE",
            "state": "GA",
            "postal_code": "302411422",
            "telephone_number": "706-882-0121",
            "fax_number": "706-882-0123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST GEORGIA MEDICAL CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-09-03",
        "last_updated": "2020-02-24",
        "certification_date": "2020-02-24",
        "status": "A",
        "authorized_official_last_name": "BUDZINSKI",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "EVP",
        "authorized_official_telephone_number": "470-644-0012",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00142843A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Twin Fountains Home",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Twin Fountains Home",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lagrange, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 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.