Augusta Abbey

NPI1467858068

Summary

Provider Details

NPI Number 1467858068
Provider Name Augusta Abbey
Credential
Specialization
Medical School Name
Graduation Year
Gender
Entity Type Individual
PAC ID by PECOS
Professional Enrollment ID
Enumeration Date 11/08/2014
Last Update Date 11/08/2014

Contact Details

Business Practice address 101 BECKETT LN, Fayetteville,
30214-7155 Georgia View on Google Map
Business Practice phone 404-918-1926
Business Practice fax 866-468-4047
Mailing address 320 MASTERS CLUB BLVD, Hampton,
30228-6048 Georgia View on Google Map
Other phone 404-918-1926
Other fax 866-468-4047
Email Address shannonfig@domain.com Reval Email Address
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Hospital Affilitation

Practices in Fayetteville

Fayetteville, Georgia

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Provider Taxonomy Details

Provider Taxonomy 1
Grouping name
Taxonomy
Primary Taxonomy
Grouping name
Taxonomy
Provider Taxonomy 3
Speciality
Grouping name
Taxonomy
Provider Taxonomy 4
Grouping name
Taxonomy

Reference NPI Information (as per NPPES NPI Record)

Field Name Field Value
NPI 1467858068
10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider.
Entity Type Individual
Code describing the type of health care provider that is being assigned an NPI. Codes are:
  • 1 = (Person): individual human being who furnishes health care;
  • 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
Is Sole Proprietor Y
Indicate whether provider is a sole proprietor.
  • A sole proprietor is the sole (the only) owner of a business that is not incorporated; that unincorporated business is a sole proprietorship.
  • In a sole proprietorship, the sole proprietor owns all of the assets of the business and is solely liable for all of the debts of the business.
  • There is no difference between a sole proprietorship and a sole proprietor; they are legally a single entity: an individual.
  • In terms of NPI assignment, a sole proprietor is an Entity type 1 (Individual) and is eligible for only one NPI (the sole proprietorship business is not eligible for its own NPI).
  • As an individual, a sole proprietorship cannot be a subpart and cannot have subparts. (See NPI Final Rule for information about subparts.)
  • A sole proprietorship may or may not have employees.
  • Often, the IRS assigns an EIN to a sole proprietorship in order to protect the sole proprietor's SSN from disclosure in claims or on W-2s. NPPES does not capture a sole proprietorship's EIN.
  • Many types of health care providers could be sole proprietorships (for example, group practices, pharmacies, home health agencies).
Provider Last Name (Legal Name) Abbey
The last name of the provider (if an individual). If the provider is an individual, this is the legal name. This name must match the name on file with the Social Security Administration (SSA). In addition, the date of birth must match that on file with SSA. (First and last names are required for initial applications.) The First, Middle, Last and Credential(s) fields allow the following special characters: ampersand, apostrophe, colon, comma, forward slash, hyphen, left and right parentheses, period, pound sign, quotation mark, and semi-colon. A field cannot contain all special characters.
Provider First Name Augusta
The first name of the provider, if the provider is an individual.
Provider Credential Text
The abbreviations for professional degrees or credentials used or held by the provider, if the provider is an individual. Examples are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations will not be verified by NPS.
Provider First Line Business Mailing Address 320 MASTERS CLUB BLVD
The first line mailing address of the provider being identified. This data element may contain the same information as ''Provider first line location address''.
Provider Business Mailing Address City Name Hampton
The City name in the mailing address of the provider being identified. This data element may contain the same information as ''Provider location address City name''.
Provider Business Mailing Address State Name Georgia
The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as ''Provider location address State name''.
Provider Business Mailing Address Postal Code 30228-6048
The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as ''Provider location address postal code''.
Provider Business Mailing Address Country Code US
The country code in the mailing address of the provider being identified. This data element may contain the same information as ''Provider location address country code''.
Provider Business Mailing Address Telephone Number 404-918-1926
The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as ''Provider location address telephone number''.
Provider Business Mailing Address Fax Number 866-468-4047
The fax number associated with the mailing address of the provider being identified. This data element may contain the same information as ''Provider location address fax number''.
Provider First Line Business Practice Location Address 101 BECKETT LN
The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Business Practice Location Address City Name Fayetteville
The city name in the location address of the provider being identified.
Provider Business Practice Location Address State Name Georgia
The State or Province name in the location address of the provider being identified.
Provider Business Practice Location Address Postal Code 30214-7155
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Business Practice Location Address Country Code US
The country code in the location address of the provider being identified.
Provider Business Practice Location Address Telephone Number 404-918-1926
The telephone number associated with the location address of the provider being identified.
Provider Business Practice Location Address Fax Number 866-468-4047
The fax number associated with the location address of the provider being identified.
Provider Enumeration Date 11/08/2014
The date the provider was assigned a unique identifier (assigned an NPI).
Last Update Date 11/08/2014
The date that a record was last updated or changed.
Healthcare Provider Taxonomy Code #1 343800000X
The Health Care Provider Taxonomy code is a unique alphanumeric code, ten characters in length. The code set is structured into three distinct "Levels" including Provider Type, Classification, and Area of Specialization.
Healthcare Provider Taxonomy 1 A public or privately owned transportation service with vehicles, specially equipped to provide enhanced safety, security and passenger restraint, and staffed by one or more individuals trained to work with patients in crisis situations resulting from mental or emotional illness and/or substance abuse.
Healthcare Provider Taxonomy #1
Healthcare Provider Primary Taxonomy Switch 1 N
Primary Taxonomy:
  • X - The primary taxonomy switch is Not Answered;
  • Y - The taxonomy is the primary taxonomy (there can be only one per NPI record);
  • N - The taxonomy is not the primary taxonomy.
Healthcare Provider Taxonomy Code #2 343900000X
The Health Care Provider Taxonomy code is a unique alphanumeric code, ten characters in length. The code set is structured into three distinct "Levels" including Provider Type, Classification, and Area of Specialization.
Healthcare Provider Taxonomy 2 A land vehicle with a capacity to meet special height, clearance, access, and seating, for the conveyance of persons in non-emergency situations. The vehicle may or may not be required to meet local county or state regulations.
Healthcare Provider Taxonomy #2
Healthcare Provider Primary Taxonomy Switch 2 Y
Primary Taxonomy:
  • X - The primary taxonomy switch is Not Answered;
  • Y - The taxonomy is the primary taxonomy (there can be only one per NPI record);
  • N - The taxonomy is not the primary taxonomy.
Healthcare Provider Taxonomy Code #3 347C00000X
The Health Care Provider Taxonomy code is a unique alphanumeric code, ten characters in length. The code set is structured into three distinct "Levels" including Provider Type, Classification, and Area of Specialization.
Healthcare Provider Taxonomy 3 An individual paid to provide non-emergency transportation using their privately owned/leased vehicle.
Healthcare Provider Taxonomy #3
Healthcare Provider Primary Taxonomy Switch 3 N
Primary Taxonomy:
  • X - The primary taxonomy switch is Not Answered;
  • Y - The taxonomy is the primary taxonomy (there can be only one per NPI record);
  • N - The taxonomy is not the primary taxonomy.
Healthcare Provider Taxonomy Code #4 347E00000X
The Health Care Provider Taxonomy code is a unique alphanumeric code, ten characters in length. The code set is structured into three distinct "Levels" including Provider Type, Classification, and Area of Specialization.
Healthcare Provider Taxonomy 4 An organization that provides transportation for individuals who need access to medical care or services and have no other means of transportation. Transportation includes, but is not limited to, wheelchair van, taxi, stretcher car, bus passes and tickets, and secured transportation.
Healthcare Provider Taxonomy #4
Healthcare Provider Primary Taxonomy Switch 4 N
Primary Taxonomy:
  • X - The primary taxonomy switch is Not Answered;
  • Y - The taxonomy is the primary taxonomy (there can be only one per NPI record);
  • N - The taxonomy is not the primary taxonomy.