CSRA PRIVATE DUTY, INC (NPI# 1396862496) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396862496 |
| Entity Type | Organization |
| Organization Name | CSRA PRIVATE DUTY, INC |
| Practice Address |
208 Gordon St Washington GA 30673-1604 |
| Mailing Address |
Po Box 254 Washington GA 30673-0254 |
| Practice Telephone | 7066783108 |
| Practice Fax Number | 7066783111 |
| Mailing Telephone | 7066783108 |
| Mailing Fax Number | 7066783111 |
| Enumeration Date | 2007-03-23 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | ROBERT R HARDY (ADMINISTRATOR) |
| Authorized Official Telephone | 7066783108 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251E00000X | Home Health | 157-R-0003 | GA | Agencies |
| Street Address |
208 GORDON ST |
| City | WASHINGTON |
| State | GA |
| Zip Code | 30673-1604 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477893766 | Andrew D Smoot | Specialist/Technologist | 119 W Robert Toombs Ave, A, Washington, GA 30673 | 2013-02-22 |
| 1033418975 | Hulin Transportation, Inc. | Respite Care | 906 Sandtown Rd., Washington, GA 30673 | 2011-03-17 |
| 1730404047 | Brian James Ackermann | Chiropractor | 22 West Robert Toombs Ave, R, Washington, GA 30673 | 2010-03-30 |
| 1922129105 | David T. Kirk and Associates | Clinic/Center | 206 Hospital Dr., Washington, GA 30673 | 2007-04-03 |
| 1316089097 | Medstar Homecare | Durable Medical Equipment & Medical Supplies | 906 Sandtown Road, Washington, GA 30673 | 2007-02-12 |
| 1639249600 | Wilkes County Board of Education | Local Education Agency (LEA) | 313 A. North Alexander Ave, Wilkes, GA 30673 | 2006-11-08 |
| 1396788097 | Wilkes County Board of Commissioners | Ambulance | 105 Marshall Street, Washington, GA 30673 | 2006-06-13 |
| 1568507879 | Charles Joseph Fievet Sr. | Pharmacist | 115 E Robert Toombs Ave, Washington, GA 30673 | 2007-02-21 |
| 1629378831 | Jessica Jo Fields | Physician Assistant | 212 Hospital Drive, Washington, GA 30673-0568 | 2010-10-22 |
| 1043263031 | Pruitthealth - Washington, LLC | Skilled Nursing Facility | 112 Hospital Drive, Washington, GA 30673-0578 | 2006-05-18 |
| Find all providers in zip 30673 | ||||
| Taxonomy Code | 251E00000X |
| Grouping | Agencies |
| Classification | Home Health |
| A public agency or private organization, or a subdivision of such an agency or organization, that is primarily engaged in providing skilled nursing services and other therapeutic services, such as physical therapy, speech-language pathology services, or occupational therapy, medical social services, and home health aide services. It has policies established by a professional group associated with the agency or organization (including at least one physician and one registered nurse) to govern the services and provides for supervision of such services by a physician or a registered nurse; maintains clinical records on all patients; is licensed in accordance with State or local law or is approved by the State or local licensing agency as meeting the licensing standards, where applicable; and meets other conditions found by the Secretary of Health and Human Services to be necessary for health and safety. |
| Notes: Source: CFR42 Chapter IV Part 484, http://www.access.gpo.gov/nara/cfr/waisidx_99/42cfr484_99.html [7/1/2007: definition added, source added] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659978013 | Virgin Health Care Services LLC | Home Health | 7317 Georgia Ave Nw, Washington, DC 20012-1719 | 2020-10-07 |
| 1609480615 | Donovan Wayne Johnson | Home Health | 1151 4th St Sw Apt 220, Washington, DC 20024-2348 | 2020-09-07 |
| 1205448982 | Monica Thompson | Home Health | 1475 Columbia Rd Nw, Washington, DC 20009-4743 | 2020-08-23 |
| 1528677747 | Fresh Fresh Health Care Agency LLC | Home Health | 5407 1st St Nw Apt 2, Washington, DC 20011-5243 | 2020-07-23 |
| 1144854522 | Essence Jones | Home Health | 1162 1st St Nw, Washington, DC 20001-1362 | 2020-02-25 |
| 1356975742 | Karen Shirelle Kouyate | Home Health | 6120 Georgia Ave Nw Apt 205, Washington, DC 20011-5169 | 2020-02-25 |
| 1538790514 | Tesfaadam Mulat Admassu | Home Health | 1405 Somerset Pl Nw Apt 203, Washington, DC 20011-1089 | 2020-01-29 |
| 1588209993 | Three Angels Home Health.llc | Home Health | 143 Kennedy St Nw Ste 15, Washington, DC 20011-5268 | 2019-11-08 |
| 1548802465 | Dominique Harden | Home Health | 1849 Good Hope Rd Se Apt 202, Washington, DC 20020-4681 | 2019-10-11 |
| 1407403645 | Allied Healthcare Group LLC | Home Health | 6120 Kansas Ave, Nw, 1st Floor, A, Washington, DC 20011 | 2019-08-22 |
| Find all providers in WASHINGTON | ||||
| City | WASHINGTON |
| Zip Code | 30673 |
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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.