Westbury McDonough LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

10751889 Issued in GA

Legal business name

WESTBURY MCDONOUGH LLC

Practice address

198 Hampton St
McDonough, GA 30253-3152

Phone

(770) 957-9081

Fax

(770) 957-3440

NPI assigned

Jun 21, 2006

Organization subpart

No

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

Authorized official

Name

Penelope W Griffin

Title

Chief Operating Officer

Phone

(770) 228-1228

Specialties & licenses 1

Addresses

Other identifiers 2

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

{
    "created_epoch": "1150848000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1503014400000",
    "number": "1902842875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "198 HAMPTON ST",
            "city": "MCDONOUGH",
            "state": "GA",
            "postal_code": "302533152",
            "telephone_number": "770-957-9081",
            "fax_number": "770-957-3440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "198 HAMPTON ST",
            "city": "MCDONOUGH",
            "state": "GA",
            "postal_code": "302533152",
            "telephone_number": "770-957-9081",
            "fax_number": "770-957-3440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WESTBURY MCDONOUGH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-21",
        "last_updated": "2017-08-18",
        "status": "A",
        "authorized_official_last_name": "GRIFFIN",
        "authorized_official_first_name": "PENELOPE",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "CHIEF OPERATING OFFICER",
        "authorized_official_telephone_number": "770-228-1228"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "GA",
            "license": "10751889",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "51001223 001",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000143525A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Skilled Nursing Facility in McDonough, GA
• Providers in McDonough, GA by specialty
• Skilled Nursing Facility in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2017; 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.