OUR LADY OF THE ROSES PRIMARY CARE (NPI# 1205207933) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205207933 |
| Entity Type | Organization |
| Organization Name | OUR LADY OF THE ROSES PRIMARY CARE |
| Practice Address |
808 21st St Columbus GA 31904-8817 |
| Mailing Address |
Po Box 1957 Fortson GA 31808-1957 |
| Practice Telephone | 7065875771 |
| Mailing Telephone | 7065875771 |
| Enumeration Date | 2015-10-07 |
| Last Update Date | 2015-10-07 |
| Authorized Official Name | MR. GERALD WILLIAM WIECZOREK (BUSINESS MANAGER) |
| Authorized Official Telephone | 7063274880 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM1000X |
Clinic/Center Specialization: Migrant Health |
RN042301 | GA | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 000901106D | 05 | |
| AL | 126693 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801119375 | Our Lady of The Roses Primary Care | General Practice | 808 21st St, Columbus, GA 31904-8817 | 2010-03-11 |
| Street Address |
808 21ST ST |
| City | COLUMBUS |
| State | GA |
| Zip Code | 31904-8817 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760445753 | Anneliese Chai | Physician Assistant | 808 21st St, Columbus, GA 31904-8817 | 2006-04-10 |
| 1801119375 | Our Lady of The Roses Primary Care | General Practice | 808 21st St, Columbus, GA 31904-8817 | 2010-03-11 |
| 1013087386 | Susan Carol Wieczorek | Nurse Practitioner | 808 21st St, Columbus, GA 31904-8817 | 2006-11-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821641457 | At Home Palliative Care, LLC | Nursing Care | 114 Enterprise Ct, Suite B, Columbus, GA 31904 | 2019-07-23 |
| 1285191049 | Shandra Ladell Grimes | Nurse Practitioner | 2300 Manchester Expwy St Francis Hospital, Suite C-001, Columbus, GA 31904 | 2019-02-27 |
| 1881161529 | Lesley Kathleen Simmons | Massage Therapist | 5402 15th Ave, Columbus, GA 31904 | 2018-10-31 |
| 1184190662 | Alphonsa Joseph | Nurse Practitioner | 2430 Brookstone Centre Parkway, Columbus, Georgia 31904, Columbus, GA 31904 | 2018-10-22 |
| 1568942704 | William Pearce Massey | Social Worker | 8851-1 Moore Road, Columbus, GA 31904 | 2018-08-17 |
| 1033696372 | Marlise V. Gray | Counselor | 2013 Devonshire Dr. Suite 115, Columbus, GA 31904 | 2018-07-19 |
| 1710418173 | Amanda Barnette Pruett | Behavioral Analyst | 200 Brookstone Centre Pkwy Bldg 200, Columbus, GA 31904 | 2017-03-27 |
| 1750833232 | Carrie Leigh Whitehead | Nurse Practitioner | 6228 Bradley Park Dr. Suite A, Columbus, GA 31904 | 2016-10-31 |
| 1609323369 | Shomika Lasha Battle | Registered Nurse | 2101 North Avenue, Columbus, GA 31904 | 2016-09-09 |
| 1952759219 | Peaceful River Home Care Agency | In Home Supportive Care | 738 Rudgate Road, Columbus, GA 31904 | 2016-05-27 |
| Find all providers in zip 31904 | ||||
| Taxonomy Code | 261QM1000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Migrant Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801239389 | East Georgia Healthcare Center Inc | Clinic/Center | 1636 Hatch Parkway South, Baxley, GA 31513 | 2013-04-15 |
| 1407011711 | Migrant Farmworkers Clinic Inc | Clinic/Center | 224 J Frank Culpepper Road, Lake Park, GA 31636 | 2008-07-25 |
Please comment or provide details below to improve the information on OUR LADY OF THE ROSES PRIMARY CARE.
| 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.