Preventive & Fitness Healthcare Agency, LLC

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

Legal business name

PREVENTIVE & FITNESS HEALTHCARE AGENCY, LLC

Practice address

1800 N Ridge Dr Ste 1
Milledgeville, GA 31061-2258

Phone

(478) 295-2955

Fax

(475) 295-3210

NPI assigned

Jan 2, 2023

Last updated

Jan 2, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Wylene Worthen, REGISTERED NURSENPI 1437624301

Title

Administrator/Owner

Phone

(478) 456-9438

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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.

• Wylene Satcher Worthen, REGISTERED NURSE

  • Nursing Care Agency
  • Milledgeville, GA
  • NPI 1437624301
  NPD Authorized official

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

{
    "created_epoch": "1672617600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1672617600000",
    "number": "1578276887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 N RIDGE DR STE 1",
            "city": "MILLEDGEVILLE",
            "state": "GA",
            "postal_code": "310612258",
            "telephone_number": "478-295-2955",
            "fax_number": "475-295-3210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 N RIDGE DR STE 1",
            "city": "MILLEDGEVILLE",
            "state": "GA",
            "postal_code": "310612258",
            "telephone_number": "478-295-2955",
            "fax_number": "475-295-3210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREVENTIVE & FITNESS HEALTHCARE AGENCY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-02",
        "last_updated": "2023-01-02",
        "certification_date": "2023-01-02",
        "status": "A",
        "authorized_official_last_name": "WORTHEN",
        "authorized_official_first_name": "WYLENE",
        "authorized_official_title_or_position": "ADMINISTRATOR/OWNER",
        "authorized_official_telephone_number": "478-456-9438",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "REGISTERED NURSE"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003232271A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shelley Hardie Pool, FNP-C
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• Primecare Hospice & Palliative Inc
• Joy W Pritchett, AUD

• In Home Supportive Care Agency in Milledgeville, GA
• Providers in Milledgeville, GA by specialty
• In Home Supportive Care Agency in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2023; 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.