NPIMap

Organization Active NPI

G.R. Jackson Senior Care

  • Home Health Agency
  • Austell, GA
National Provider Identifier
1467742858
Registry record updated Apr 19, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
CN0028902879 Issued in GA
Legal business name
G.R. JACKSON SENIOR CARE
Practice address
1325 Six Flags Dr
#1207
Austell, GA 30168-7065
Phone
(404) 274-4498
Fax
(678) 324-6791
NPI assigned
Apr 19, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 19, 2011

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

Authorized official

Name
Mrs. Orteasa Maria Tafie, CNANPI 1366732802
Title
Owner
Phone
(404) 274-4498

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X CN0028902879 GA Primary

Addresses

Primary practice location

1325 Six Flags Dr
#1207
Austell, GA 30168-7065

Mailing address

1325 Six Flags Dr
#1207
Austell, GA 30168-7065
Phone (404) 274-4498

National Provider Directory

National Provider Directory

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": "1303171200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1303171200000",
    "number": "1467742858",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1325 SIX FLAGS DR",
            "address_2": "#1207",
            "city": "AUSTELL",
            "state": "GA",
            "postal_code": "301687065",
            "telephone_number": "404-274-4498",
            "fax_number": "678-324-6791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1325 SIX FLAGS DR",
            "address_2": "#1207",
            "city": "AUSTELL",
            "state": "GA",
            "postal_code": "301687065",
            "telephone_number": "404-274-4498",
            "fax_number": "678-324-6791"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "G.R. JACKSON SENIOR CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-04-19",
        "last_updated": "2011-04-19",
        "status": "A",
        "authorized_official_last_name": "TAFIE",
        "authorized_official_first_name": "ORTEASA",
        "authorized_official_middle_name": "MARIA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "404-274-4498",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "CNA"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "GA",
            "license": "CN0028902879",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austell, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2011; 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.