Healthcare at College Park, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

HEALTHCARE AT COLLEGE PARK, LLC

Practice address

1765 Temple Ave
College Park, GA 30337-2736

Phone

(404) 767-8609

Fax

(404) 766-2957

NPI assigned

Mar 27, 2015

Organization subpart

No

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

Authorized official

Name

Michael E Winget Jr.

Title

Secretary

Phone

(478) 974-0006

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1427414400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1427414400000",
    "number": "1730573734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1765 TEMPLE AVE",
            "city": "COLLEGE PARK",
            "state": "GA",
            "postal_code": "303372736",
            "telephone_number": "404-767-8609",
            "fax_number": "404-766-2957"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1765 TEMPLE AVE",
            "city": "COLLEGE PARK",
            "state": "GA",
            "postal_code": "303372736",
            "telephone_number": "404-767-8609",
            "fax_number": "404-766-2957"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTHCARE AT COLLEGE PARK, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-03-27",
        "last_updated": "2015-03-27",
        "status": "A",
        "authorized_official_last_name": "WINGET",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "478-974-0006",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000140654A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 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.