NPIMap

Organization Active NPI

Ga Department of Human Resources

Doing business as ECRH Skilled Nursing Home No 9

  • Skilled Nursing Facility
  • Gracewood, GA
National Provider Identifier
1639166234
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
1121694 Issued in GA
Legal business name
GA DEPARTMENT OF HUMAN RESOURCES
Doing business as
ECRH Skilled Nursing Home No 9
Practice address
100 Myrtle Blvd
Gracewood, GA 30812-1500
Phone
(706) 790-2042
Fax
(706) 790-2476
NPI assigned
Sep 29, 2005
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Gail C Jackson, M.D.NPI 1417165531
Title
Regional Hospital Administrator
Phone
(706) 790-2030

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 1121694 GA Primary

Addresses

Primary practice location

100 Myrtle Blvd
Gracewood, GA 30812-1500

Mailing address

100 Myrtle Blvd
Gracewood, GA 30812-1500
Phone (706) 790-2042

Other names 1

  • ECRH Skilled Nursing Home No 9 Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Ga Regional Hosp August74 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

100 Myrtle Blvd
Gracewood, GA 30812
Phone (706) 790-2030

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": "1127952000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1639166234",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MYRTLE BLVD",
            "city": "GRACEWOOD",
            "state": "GA",
            "postal_code": "308121500",
            "telephone_number": "706-790-2042",
            "fax_number": "706-790-2476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 MYRTLE BLVD",
            "city": "GRACEWOOD",
            "state": "GA",
            "postal_code": "308121500",
            "telephone_number": "706-790-2042",
            "fax_number": "706-790-2476"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GA DEPARTMENT OF HUMAN RESOURCES",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-29",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "GAIL",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "REGIONAL HOSPITAL ADMINISTRATOR",
        "authorized_official_telephone_number": "706-790-2030",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "GA",
            "license": "1121694",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ECRH Skilled Nursing Home No 9",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Gracewood, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.