NPIMap

Organization Active NPI

Paulding Medical Center, Inc.

  • Skilled Nursing Facility
  • Dallas, GA
National Provider Identifier
1962473355
Registry record updated Feb 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
11101433 Issued in GA
Legal business name
PAULDING MEDICAL CENTER, INC.
Practice address
600 W Memorial Dr
Attn: Carol O'Connell
Dallas, GA 30132-4117
Phone
(470) 644-0012
NPI assigned
Feb 1, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2020

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

Authorized official

Name
Anthony J Budzinski
Title
Evp
Phone
(470) 644-0012

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 11101433 GA Primary

Addresses

Primary practice location

600 W Memorial Dr
Attn: Carol O'Connell
Dallas, GA 30132-4117

Mailing address

600 W Memorial Dr
Attn: Carol O'Connell
Dallas, GA 30132-4117
Phone (770) 443-4762

Other identifiers 1

IdentifierTypeStateIssuer
00142359AMedicaidGA

Other names 1

  • WellStar Paulding Nursing Center Doing business as

National Provider Directory

National Provider Directory

Locations

144 Bill Carruth Pkwy
Ste 2700
Hiram, GA 30141
Phone (470) 644-8040

144 Bill Carruth Pkwy
Ste 3400
Hiram, GA 30141
Phone (470) 644-7235

144 Bill Carruth Pkwy
Ste 1200
Hiram, GA 30141
Phone (470) 644-8035

148 Bill Carruth Pkwy
Ste 290
Hiram, GA 30141
Phone (470) 644-1709

Practitioners & affiliated clinicians

Practitioners 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1138752000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1582502400000",
    "number": "1962473355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 W MEMORIAL DR",
            "address_2": "ATTN: CAROL O'CONNELL",
            "city": "DALLAS",
            "state": "GA",
            "postal_code": "301324117",
            "telephone_number": "770-443-4762",
            "fax_number": "770-443-4793"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 W MEMORIAL DR",
            "address_2": "ATTN: CAROL O'CONNELL",
            "city": "DALLAS",
            "state": "GA",
            "postal_code": "301324117",
            "telephone_number": "470-644-0012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAULDING MEDICAL CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-01",
        "last_updated": "2020-02-24",
        "certification_date": "2020-02-24",
        "status": "A",
        "authorized_official_last_name": "BUDZINSKI",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "EVP",
        "authorized_official_telephone_number": "470-644-0012"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "GA",
            "license": "11101433",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00142359A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "WellStar Paulding Nursing Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "WellStar Paulding Nursing Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Dallas, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 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.

Verify at the official NPI Registry.