Iris Cove Personal Care Home

Primary specialty

Custodial Care FacilityTaxonomy code 311Z00000X

License

LCB20130000967 Issued in GA

Legal business name

IRIS COVE PERSONAL CARE HOME

Practice address

2382 Wheeless Rd
Augusta, GA 30906-5404

Phone

(706) 723-5949

NPI assigned

Jan 30, 2015

Last updated

Jan 30, 2015By 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

Nicole BentleyNPI 1962829234

Title

Owner

Phone

(706) 306-0273

Specialties & licenses 1

Addresses

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.

• Nicole E Bentley

  • Personal Care Attendant
  • Augusta, GA
  • NPI 1962829234
  NPD (past) Authorized official

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

{
    "created_epoch": "1422576000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1422576000000",
    "number": "1902296866",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2382 WHEELESS RD",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309065404",
            "telephone_number": "706-723-5949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2382 WHEELESS RD",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309065404",
            "telephone_number": "706-723-5949"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IRIS COVE PERSONAL CARE HOME",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-30",
        "last_updated": "2015-01-30",
        "status": "A",
        "authorized_official_last_name": "BENTLEY",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "706-306-0273"
    },
    "taxonomies": [
        {
            "code": "311Z00000X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility",
            "state": "GA",
            "license": "LCB20130000967",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Interpoint Health
• Interventional and Alternative Spine and Wellness, LLC
• Interventional Spine and Pain Management Center, PC (Alliance Spine and Pain Centers)
• Interventional Spine and Pain Management Center, PC (Alliance Spine and Pain Centers)
• Omar Iqbal, MD
• Iris Cove Personal Care Home LLC
• Laura Smith Irwin, MD MPH
• Carlos M. Isales, MD
• Aaminah Ishmael
• Shaheen Ul Islam, MBBS

• Custodial Care Facility in Augusta, GA
• Providers in Augusta, GA by specialty
• Custodial Care Facility in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 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.