NPIMap

Organization Active NPI

University Extended Care Inc

  • Skilled Nursing Facility
  • Evans, GA
National Provider Identifier
1922094945
Registry record updated May 5, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
LTC1036959 Issued in GA
Legal business name
UNIVERSITY EXTENDED CARE INC
Practice address
561 University Drive
Evans, GA 30809
Phone
(706) 863-7514
Fax
(706) 855-9580
NPI assigned
Sep 26, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 5, 2010

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

Authorized official

Name
Mr. Keith Wayne Austin
Title
Administrator
Phone
(706) 863-7514

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X LTC1036959 GA Primary

Addresses

Primary practice location

561 University Drive
Evans, GA 30809

Mailing address

1230 Walton Way
Augusta, GA 30901-2142
Phone (706) 828-2512

Other identifiers 1

IdentifierTypeStateIssuer
000219359AMedicaidGA

Other names 1

  • Westwood Nursing Home Doing business as

National Provider Directory

National Provider Directory

Member organizations 9

Organizations listed as members of this organization in the National Provider Directory.

Locations

1230 Walton Way
Augusta, GA 30901
Phone (706) 828-2374

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1127692800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1273017600000",
    "number": "1922094945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1230 WALTON WAY",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309012142",
            "telephone_number": "706-828-2512",
            "fax_number": "706-828-2514"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "561 UNIVERSITY DRIVE",
            "city": "EVANS",
            "state": "GA",
            "postal_code": "30809",
            "telephone_number": "706-863-7514",
            "fax_number": "706-855-9580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSITY EXTENDED CARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-26",
        "last_updated": "2010-05-05",
        "status": "A",
        "authorized_official_last_name": "AUSTIN",
        "authorized_official_first_name": "KEITH",
        "authorized_official_middle_name": "WAYNE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "706-863-7514",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "GA",
            "license": "LTC1036959",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000219359A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Westwood Nursing Home",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Evans, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2010; 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.