Active NPI
William C Byrd Inc
- Assisted Living Facility
- Tifton, GA
National Provider Identifier
1821156852
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Assisted Living Facility
- Legal business name
- WILLIAM C BYRD INC
- Practice address
- 405 North Ridge Avenue
Tifton, GA 31794 - Phone
- (229) 387-0940
- Fax
- (229) 386-9307
- NPI assigned
- Dec 4, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. William C Byrd
- Title
- Owner President
- Phone
- (229) 382-8655
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Assisted Living Facility | 310400000X | GA | Primary |
Addresses
Primary practice location
405 North Ridge Avenue
Tifton, GA 31794
Mailing address
PO Box 890
Tifton, GA 31794
Phone (229) 382-8655
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00747766A | Medicaid | GA |
Other names 1
- Grace Manor
National Provider Directory
National Provider Directory- Tax ID family
- Bradley Place
Other organizations with this tax ID 5
Organizations that report the same tax identification number in the National Provider Directory.
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- Assisted Living Facility
- Moultrie, GA
- NPI 1053489252
-
- Assisted Living Facility
- Tifton, GA
- NPI 1376601302
-
- Assisted Living Facility
- Tifton, GA
- NPI 1639237662
-
- Assisted Living Facility
- Moultrie, GA
- NPI 1720146756
-
- Assisted Living Facility
- Tifton, GA
- NPI 1962570168
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165190400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1821156852",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 890",
"city": "TIFTON",
"state": "GA",
"postal_code": "31794",
"telephone_number": "229-382-8655",
"fax_number": "229-382-7011"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "405 NORTH RIDGE AVENUE",
"city": "TIFTON",
"state": "GA",
"postal_code": "31794",
"telephone_number": "229-387-0940",
"fax_number": "229-386-9307"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "WILLIAM C BYRD INC",
"organizational_subpart": "NO",
"enumeration_date": "2006-12-04",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "BYRD",
"authorized_official_first_name": "WILLIAM",
"authorized_official_middle_name": "C",
"authorized_official_title_or_position": "OWNER PRESIDENT",
"authorized_official_telephone_number": "229-382-8655",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "310400000X",
"taxonomy_group": "",
"desc": "Assisted Living Facility",
"state": "GA",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00747766A",
"state": "GA"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Grace Manor",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Tifton, 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.