Glascock County Health Care LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

1-062-1049 Issued in GA

Legal business name

GLASCOCK COUNTY HEALTH CARE LLC

Doing business as

Gibson Health and Rehabilitation

Practice address

434 Beall Springs Rd
Gibson, GA 30810-4224

Phone

(706) 598-3201

Fax

(706) 598-3802

NPI assigned

Sep 7, 2005

Last updated

Feb 6, 2013By 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

Patrelle Major

Title

Administrator

Phone

(706) 598-3201

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Gibson Health and Rehabilitation Doing business as

Tax ID family

Gibson Health and Rehabilitation2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Stroud, Incorporated

  • Nursing Facility Supplies (DME)
  • Hawkinsville, GA
  • NPI 1164628962
  NPD tax ID

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

{
    "created_epoch": "1126051200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1360108800000",
    "number": "1972597847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "434 BEALL SPRINGS ROAD",
            "city": "GIBSON",
            "state": "GA",
            "postal_code": "30810",
            "telephone_number": "706-598-5301",
            "fax_number": "706-598-3802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "434 BEALL SPRINGS RD",
            "city": "GIBSON",
            "state": "GA",
            "postal_code": "308104224",
            "telephone_number": "706-598-3201",
            "fax_number": "706-598-3802"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLASCOCK COUNTY HEALTH CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-07",
        "last_updated": "2013-02-06",
        "status": "A",
        "authorized_official_last_name": "MAJOR",
        "authorized_official_first_name": "PATRELLE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "706-598-3201"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "GA",
            "license": "1-062-1049",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000141116A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Gibson Health and Rehabilitation",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Gibson Health Opco LLC
• Glascock County Board of Health (Glascock County Health Department)
• Glascock County Board of Health (Glascock County Health Deartment)
• Glascock County Boe
• Glascock County Health Care LLC (The Southern Living Center)
• Nona Joe Lord, RN, BSN
• Holly Lynn Stewart, FNP-C
• Debbie B Williford, LMT

• Skilled Nursing Facility in Gibson, GA
• Providers in Gibson, 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 Feb 6, 2013; 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.