ANGELS OF GRACE COMMUNITY WELLNESS CENTER, INC. (NPI# 1154810844) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154810844 |
| Entity Type | Organization |
| Organization Name | ANGELS OF GRACE COMMUNITY WELLNESS CENTER, INC. |
| Practice Address |
195 Martin Luther King Jr Ave Sw Cairo GA 39828-2605 |
| Mailing Address |
Po Box 1510 Cairo GA 39828-0970 |
| Practice Telephone | 2293979355 |
| Enumeration Date | 2018-05-08 |
| Last Update Date | 2020-06-13 |
| Authorized Official Name | DR. MARY WEAVER-ANDERSON (CEO) |
| Authorized Official Telephone | 2293979355 |
| Authorized Official Credential | DRPH |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261Q00000X | Clinic/Center | Ambulatory Health Care Facilities |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | ANGELS OF GRACE COMMUNITY WELLNESS CENTER, INC. | 143 9th St Sw, Cairo, GA 39828-2526 |
| Street Address |
195 MARTIN LUTHER KING JR AVE SW |
| City | CAIRO |
| State | GA |
| Zip Code | 39828-2605 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447335856 | Willie Adams, Jr. | Obstetrics & Gynecology | 195 Martin Luther King Jr Ave Sw, Cairo, GA 39828-2605 | 2006-10-25 |
| 1104441039 | April Monika Washington | Nurse Practitioner | 195 Martin Luther King Jr Ave Sw, Cairo, GA 39828-2605 | 2020-06-16 |
| 1629531694 | Weaver-anderson Medical Center, LLC | Clinic/Center | 195 Martin Luther King Jr Ave Sw, Cairo, GA 39828-2605 | 2019-04-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033621776 | Morgan Charlotte Jackson | Nurse Practitioner | 700 14th Ave Nw, Cairo, GA 39828 | 2017-11-03 |
| 1861750457 | Megan Baggett | Pharmacist | 496 Hwy 84 E, Cairo, GA 39828 | 2012-05-02 |
| 1477852176 | Laurance W Neubauer | Pharmacist | 496 Highway 84 East, Cairo, GA 39828 | 2011-03-21 |
| 1952622466 | Magictouchsouthernlivingllc | Home Health | 2039 Hwy 111 North, 2039, Cairo, GA 39828 | 2010-06-18 |
| 1306965330 | Winston Burnum Brock Jr. | Pharmacist | 496 Hwy 84 East, Rite Aid, Cairo, GA 39828 | 2007-03-29 |
| 1578605911 | Linda Inez Walden | Family Medicine | 91 Mlk Jr Ave Sw, Cairo, GA 39828 | 2007-02-13 |
| 1932252004 | Cairo Family Medical Center, PC | Family Medicine | 91 Mlk Jr Ave S.w., Cairo, GA 39828 | 2007-01-19 |
| 1144399163 | Hometown Homecare LLC | Durable Medical Equipment & Medical Supplies | 135 2nd Avenue Se, Cairo, GA 39828 | 2006-11-06 |
| 1366546582 | Arlie Dewey Phelps Jr. | Chiropractor | 26 3rd Ave Nw, Cairo, GA 39828 | 2006-09-08 |
| 1346279676 | Lonnie R Harrison | Dentist | 80 Alton Hall Rd, Cairo, GA 39828 | 2006-06-30 |
| Find all providers in zip 39828 | ||||
| Taxonomy Code | 261Q00000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629531694 | Weaver-anderson Medical Center, LLC | Clinic/Center | 195 Martin Luther King Jr Ave Sw, Cairo, GA 39828-2605 | 2019-04-08 |
| 1023361243 | Delta Center, Inc. | Clinic/Center | 1400 Commercial Ave, Cairo, IL 62914-1978 | 2012-10-25 |
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| 1154937050 | Staywellatl,llc | Clinic/Center | 2550 Heritage Ct Se Ste 135, Atlanta, GA 30339-3528 | 2020-09-17 |
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| 1518585868 | Robin June Dc, LLC | Clinic/Center | 400 Embassy Row Ste 110, Sandy Springs, GA 30328-5723 | 2020-07-13 |
| 1740808773 | All Test Services | Clinic/Center | 575 Sigman Rd Ne, Conyers, GA 30013-1311 | 2020-07-07 |
| 1134741580 | Knowles Exams & More | Clinic/Center | 123 Glyndale Dr Ste 107, Brunswick, GA 31520-1404 | 2020-05-08 |
| 1558981985 | Elite Mens' Health, LLC | Clinic/Center | 3361 Nottinghill Ln, Valdosta, GA 31605-5874 | 2020-04-27 |
| 1447886320 | Momentum Rehab & Therapy | Clinic/Center | 5349 Snapfinger Woods Dr, Decatur, GA 30035-4028 | 2020-03-23 |
| 1073146759 | Transitional Care Clinic LLC | Clinic/Center | 2084 Newnan Crossing Blvd E Ste 300, Newnan, GA 30265-2561 | 2020-02-20 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.