Memorial Careone Home Health Services Inc

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

137111 Issued in GA

Legal business name

MEMORIAL CAREONE HOME HEALTH SERVICES INC

Doing business as

CareOne Home Health Services-Tifton Agency

Practice address

1823 Old Ocilla Rd
Tifton, GA 31794-1617

Phone

(229) 382-0686

Fax

(229) 386-5384

NPI assigned

Aug 4, 2006

Last updated

Apr 20, 2008By 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 3

Other names 1

• CareOne Home Health Services-Tifton 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": "1208649600000",
    "number": "1962410886",
    "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": "1823 OLD OCILLA RD",
            "city": "TIFTON",
            "state": "GA",
            "postal_code": "317941617",
            "telephone_number": "229-382-0686",
            "fax_number": "229-386-5384"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEMORIAL CAREONE HOME HEALTH SERVICES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-04",
        "last_updated": "2008-04-20",
        "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": "137111",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS BLUESHIELD INS",
            "identifier": "52158848002",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "JCAHO",
            "identifier": "117423",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00336872A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CareOne Home Health Services-Tifton Agency",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Home Health Agency in Tifton, GA
• Providers in Tifton, 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 Apr 20, 2008; 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.