NPIMap

Organization Active NPI

N/a at Present Time, Will Be Working Contractprivateduty

  • Nursing Care Agency
  • Lagrange, GA
National Provider Identifier
1679958003
Registry record updated Jul 28, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nursing Care AgencyTaxonomy code 251J00000X
License
CN0000047840 Issued in GA
Legal business name
N/A AT PRESENT TIME, WILL BE WORKING CONTRACTPRIVATEDUTY
Practice address
401A Boulevard
401Aboulevard
Lagrange, GA 30240-3009
Phone
(706) 333-9369
NPI assigned
Jul 28, 2015
Last updated
Jul 28, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2015

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

Authorized official

Name
Miss Lisa Potts, CERTIFIED NURSING ASNPI 1679006753
Title
Cna
Phone
(706) 333-9369

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nursing Care Agency 251J00000X CN0000047840 GA Primary
Nurse's AideGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 376K00000X CN0000047840 AL

Addresses

Primary practice location

401A Boulevard
401Aboulevard
Lagrange, GA 30240-3009

Mailing address

401A Boulevard
401Aboulevard
Lagrange, GA 30240-3009
Phone (706) 333-9369

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, 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": "1438041600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1438041600000",
    "number": "1679958003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401A BOULEVARD",
            "address_2": "401ABOULEVARD",
            "city": "LAGRANGE",
            "state": "GA",
            "postal_code": "302403009",
            "telephone_number": "706-333-9369"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401A BOULEVARD",
            "address_2": "401ABOULEVARD",
            "city": "LAGRANGE",
            "state": "GA",
            "postal_code": "302403009",
            "telephone_number": "706-333-9369"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "N/A AT PRESENT TIME, WILL BE WORKING CONTRACTPRIVATEDUTY",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-28",
        "last_updated": "2015-07-28",
        "status": "A",
        "authorized_official_last_name": "POTTS",
        "authorized_official_first_name": "LISA",
        "authorized_official_title_or_position": "CNA",
        "authorized_official_telephone_number": "706-333-9369",
        "authorized_official_name_prefix": "Miss",
        "authorized_official_credential": "CERTIFIED NURSING AS"
    },
    "taxonomies": [
        {
            "code": "251J00000X",
            "taxonomy_group": "",
            "desc": "Nursing Care",
            "state": "GA",
            "license": "CN0000047840",
            "primary": true
        },
        {
            "code": "376K00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nurse's Aide",
            "state": "AL",
            "license": "CN0000047840",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Jul 28, 2015; 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.