EMORY UNIVERSITY (EMORY UNIVERSITY HOSPITAL AT WESLEY WOODS) - NPI NUMBER 1770560294

Summary

Provider Name: EMORY UNIVERSITY (EMORY UNIVERSITY HOSPITAL AT WESLEY WOODS)

NPI Number: 1770560294

Clasification: General Acute Care Hospital (282N00000X)

Address:
1821 CLIFTON RD NE
ATLANTA, GA
ZIP 30329

Phone Number: (404) 686-7041



Detailed Information

EMORY UNIVERSITY is a general acute care hospital in Atlanta, GA. The provider is an acute general hospital is an institution whose primary function is to provide inpatient diagnostic and therapeutic services for a variety of medical conditions, both surgical and non-surgical, to a wide population group. The hospital treats patients in an acute phase of illness or injury, characterized by a single episode or a fairly short duration, from which the patient returns to his or her normal or previous level of activity. The assigned NPI number for this provider is 1770560294 and is registered as an organization entity type.
The provider Is Doing Business As Emory University Hospital At Wesley Woods.

The provider's business address is:

1821 CLIFTON RD NE
ATLANTA, GA
ZIP 30329-021
Phone: (404) 686-7041
Fax: (404) 712-5731

The provider's authorized official is Jimmy T Hatcher .
The authorized official title is Cfo Emory Healthcare and has the following contact phone number (404) 686-2983.

The enumeration date for this NPI number is 12/27/2005 and was last updated on 7/3/2014.

Map - Location of Practice

Taxonomy Codes

The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1 282N00000X General Acute Care Hospital 044-565 GA Yes

Other (Legacy) Identifiers

The following legacy identifiers are available for this provider:

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1 110203 MEDICARE ID-TYPE UNSPECIFIED GA WESLEY GERIARTIC
2 00339831A MEDICAID GA

NPI Record

No. Field Name Field Value Field Definition 1
1 NPI 1770560294 The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
2 Entity Type Code 2 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).
3 Employer Identification Number EIN The Employer Identification Number (EIN), assigned by the IRS, of the provider being identified.
4 Provider Organization Name Legal Business Name EMORY UNIVERSITY The name of the organization provider. If the provider is an organization, this is the legal business name.
5 Provider Other Organization Name EMORY UNIVERSITY HOSPITAL AT WESLEY WOODS Other name by which the organization provider is or has been known.
6 Provider Other Organization Name Type Code 3 Code identifying the type of other name. Codes are: 1 = former name; 2 = professional name; 3 = doing business as (d/b/ a) name; 4 = former legal business name; 5 = other.
7 Provider First Line Business Practice Location Address 1821 CLIFTON RD NE 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.
8 Provider Business Practice Location Address City Name ATLANTA The city name in the location address of the provider being identified.
9 Provider Business Practice Location Address State Name GA The State code in the location of the provider being identified.
10 Provider Business Practice Location Address Postal Code 303294021 The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
11 Provider Business Practice Location Address Country Code If outside U S US The country code in the location address of the provider being identified.
12 Provider Business Practice Location Address Telephone Number 4046867041 The telephone number associated with the location address of the provider being identified.
13 Provider Business Practice Location Address Fax Number 4047125731 The fax number associated with the location address of the provider being identified.
14 Provider Enumeration Date 12/27/2005 The date the provider was assigned a unique identifier (assigned an NPI).
15 Last Update Date 7/3/2014 The date that a record was last updated or changed.
16 Authorized Official Last Name HATCHER The last name of the person authorized to submit the NPI application or to change NPS data for a health care provider.
17 Authorized Official First Name JIMMY The first name of the authorized official.
18 Authorized Official Middle Name T The middle name of the authorized official.
19 Authorized Official Title or Position CFO EMORY HEALTHCARE The title or position of the authorized official.
20 Authorized Official Telephone Number 4046862983 The 10-position telephone number of the authorized official.
21 Healthcare Provider Taxonomy Code 1 282N00000X Code designating the provider type, classification, and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1.
22 Provider License Number 1 044-565 The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with ‘‘provider taxonomy code’’.
23 Provider License Number State Code 1 GA The code representing the State that issued the license to the provider being identified. This field can accommodate multiple States. It is associated with ‘‘provider license number.
24 Healthcare Provider Primary Taxonomy Switch 1 Y
25 Other Provider Identifier 1 110203 Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
26 Other Provider Identifier Type Code 1 04 Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
27 Other Provider Identifier State 1 GA
28 Other Provider Identifier Issuer 1 WESLEY GERIARTIC
29 Other Provider Identifier 2 00339831A Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
30 Other Provider Identifier Type Code 2 05 Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
31 Other Provider Identifier State 2 GA
32 Is Organization Subpart N
33 Authorized Official Name Prefix Text MR.

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This page was last updated on: 3/10/2015

(1) Field Definition Source-. Federal Register / Vol. 69, No. 15 / Friday, January 23, 2004 / Rules and Regulations - Part II Department of Health and Human Services Office of the Secretary 45 CFR Part 162 HIPAA Administrative Simplification: Standard Unique Health Identifier for Health Care Providers; Final Rule

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