OrganizationActive
Grady Health System
NPI 1013211564 · Critical Access Hospital · Fayetteville, GA
Provider details
- NPI number
- 1013211564
- Entity type
- Organization
- Primary specialty
- Critical Access HospitalHospitals
- Organization subpart
- No
- Authorized official
- Latoya Wise, Anesthetist(404) 379-7052
- License
- 161834 (GA)
Specialties & taxonomies
Hospitals
Profile Score
Detailed profile(82/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
15 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
180 Victoria Dr
Fayetteville, GA 30214-1163
Phone: (404) 379-7052
Street-level locationGet directions
Mailing address
180 Victoria Dr
Fayetteville, GA 30214-1163
Registry dates
- Enumerated
- 2010-12-26
- Last updated
- 2010-12-26
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.