Memorial Careone Home Health Services, Inc

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

138-112 Issued in GA

Legal business name

MEMORIAL CAREONE HOME HEALTH SERVICES, INC

Doing business as

CareOne Home Health Services-Vidalia Agency

Practice address

201 Maple Dr
Vidalia, GA 30474-8906

Phone

(912) 537-9004

Fax

(912) 537-0235

NPI assigned

Aug 4, 2006

Last updated

Oct 31, 2007By 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

Ms. Deanna M. Wildes, RN

Title

Director of Operations

Phone

(912) 350-6559

Specialties & licenses 1

Addresses

Other identifiers 4

Other names 1

• CareOne Home Health Services-Vidalia Agency Doing business as

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

{
    "created_epoch": "1154649600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193788800000",
    "number": "1790793628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 931861",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "311981861",
            "telephone_number": "912-350-6405",
            "fax_number": "912-350-6413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 MAPLE DR",
            "city": "VIDALIA",
            "state": "GA",
            "postal_code": "304748906",
            "telephone_number": "912-537-9004",
            "fax_number": "912-537-0235"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEMORIAL CAREONE HOME HEALTH SERVICES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-04",
        "last_updated": "2007-10-31",
        "status": "A",
        "authorized_official_last_name": "WILDES",
        "authorized_official_first_name": "DEANNA",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "DIRECTOR OF OPERATIONS",
        "authorized_official_telephone_number": "912-350-6559",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "GA",
            "license": "138-112",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00336894A",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "JCAHO",
            "identifier": "117423",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "5817100600 006",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "51000682 001",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CareOne Home Health Services-Vidalia Agency",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Home Health Agency in Vidalia, GA
• Providers in Vidalia, GA by specialty
• Home Health Agency in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2007; 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.