PARKSIDE HOMES (NPI# 1457783094) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457783094 |
| Entity Type | Organization |
| Organization Name | PARKSIDE HOMES |
| Practice Address |
119 4th St Sw Moultrie GA 31768-4547 |
| Mailing Address |
Po Box 2132 Moultrie GA 31776-2132 |
| Practice Telephone | 2297980170 |
| Mailing Telephone | 2297980170 |
| Enumeration Date | 2013-08-06 |
| Last Update Date | 2013-08-06 |
| Authorized Official Name | MR. WAYLAND SMITH SMITH (OWNER) |
| Authorized Official Telephone | 2297980170 |
| Authorized Official Credential | RN |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 311Z00000X | Custodial Care Facility | Nursing & Custodial Care Facilities |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Colorado Business Entities | Parkside Homes of Wyoming, LLC | 1600 Specht Point Dr, Ste F, Fort Collins, CO 80525 |
| Colorado Business Entities | PARKSIDE HOMES, LLC | 2296 Lindsay Drive, Carlsbad, CA 92008 |
| Washington State Corporations | PARKSIDE HOMES, LLC | 1230 E Mason Lake Dr S, Grapeview, WA 98546 |
| Street Address |
119 4TH ST SW |
| City | MOULTRIE |
| State | GA |
| Zip Code | 31768-4547 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831521459 | Wayland Smith | Registered Nurse | 119 4th St Sw, Moultrie, GA 31768-4547 | 2013-08-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356975452 | Zachary Schiffer | Specialist/Technologist | 3131 S Main Street, Moultrie, GA 31768 | 2020-02-27 |
| 1326697731 | Daisy Concierge Care | Nursing Care | 437 S. Morris Rd Lt 1, Moultrie, GA 31768 | 2019-09-09 |
| 1194208751 | Regina Mercer Ward | Nurse Practitioner | 1724 Villa Dr Sw, Moultrie, GA 31768 | 2018-09-10 |
| 1225473630 | Moultrie Orthodontics, P.C. | Clinic/Center | 12 Longleaf Office Park, Moultrie, GA 31768 | 2013-04-30 |
| 1497032239 | Freds Stores of Tennessee Inc | Pharmacy | 2601 South Main Street, Moultrie, GA 31768 | 2011-11-08 |
| 1821382672 | Colquitt Regional Ob/gyn, LLC | Obstetrics & Gynecology | 3 Sweet Bay Ct, Moultrie, GA 31768 | 2011-06-08 |
| 1568779809 | Shana Goodno | Nurse Practitioner | 207 31 St Ave Se, Moultrie, GA 31768 | 2010-09-08 |
| 1508177445 | Cherokee Rose Emergency Physicians | Emergency Medicine | 3131 South Main Street, Moultrie, GA 31768 | 2010-06-25 |
| 1023299963 | Hetal Patel | Counselor | 600 2nd St South East, Moultrie, GA 31768 | 2007-11-20 |
| 1720146756 | William C Byrd Inc | Assisted Living Facility | 498 5th Street Se, Moultrie, GA 31768 | 2006-12-04 |
| Find all providers in zip 31768 | ||||
| Taxonomy Code | 311Z00000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Custodial Care Facility |
| A facility providing care that serves to assist an individual in the activities of daily living, such as assistance in walking, getting in and out of bed, bathing, dressing, feeding, and using the toilet, preparation of special diets, and supervision of medication that usually can be self-administered. Custodial care essentially is personal care that does not require the continuing attention of trained medical or paramedical personnel. |
| Notes: Source: Paraphrased from Section 3159 A3 of the Medicare Intermediary Manual. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578181574 | Eac Home Solutions LLC | Custodial Care Facility | 6319 Willowbrook Dr, Riverdale, GA 30296-2941 | 2020-07-07 |
| 1417511841 | Browns Tender-hearted Care | Custodial Care Facility | 116 Virginia Ln, Climax, GA 39834-2872 | 2019-05-01 |
| 1619407822 | New Hope Assistant Living of Georgia, Inc | Custodial Care Facility | 3985 Flat Shoals Rd, Union City, GA 30291-1588 | 2017-06-20 |
| 1407386204 | Cartersville Personal Care Home | Custodial Care Facility | 5 Bowen Ct, Cartersville, GA 30120-2493 | 2017-06-14 |
| 1326577255 | Monticello Personal Care Home | Custodial Care Facility | 825 Eatonton St, Monticello, GA 31064-1029 | 2017-06-05 |
| 1932631199 | Altruistic Adult Daycare | Custodial Care Facility | 2245 Dillard St, Tucker, GA 30084-4824 | 2017-03-28 |
| 1861937443 | Daily Grace Adult Day Health Services, Inc | Custodial Care Facility | 868 Highway 49, Macon, GA 31211 | 2017-01-05 |
| 1730534702 | Total Package Home Care | Custodial Care Facility | 3361 Shirehill Ln, Columbus, GA 31909-4706 | 2016-04-27 |
| 1528436227 | Comforters Adult Daycare | Custodial Care Facility | 5939 Stewart Pkwy, Douglasville, GA 30135-2371 | 2015-09-11 |
| 1427446160 | Osa Healthcare Inc | Custodial Care Facility | 1215 Eagles Landing Pkwy Ste 209b, Stockbridge, GA 30281-7280 | 2015-01-05 |
| Find all providers with the same taxonomy | ||||
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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.