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WATKINSVILLE OPCO LLC
NPI 1053024174
Assisted Living Facility in Watkinsville, GA

Active since January 04, 2023CLIA 11D2233356 · Waiver
2040 RESURGENCE DR, WATKINSVILLE, GA 30677(706) 521-0550 Get Directions Write a Review

NPPES record last updated: January 4, 2023. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Watkinsville Opco Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

WATKINSVILLE OPCO LLC (NPI 1053024174), doing business as St Gabriel Of Athens, is a healthcare organization registered as an assisted living facility in Watkinsville, Georgia and active in the NPI registry since January 2023. The organization holds a CLIA Waiver certificate valid through May 10, 2028 and lists Charles E Trefzger, Manager, as its authorized official.

NPPES Registry Identity

NPI1053024174
Entity TypeOrganization
Primary Taxonomy310400000X
Legal Business NameWATKINSVILLE OPCO LLC
Location Address2040 RESURGENCE DRWatkinsville, GA 30677-7219
Mailing AddressPo Box 2568Hickory, NC 28603-2568 · (828) 322-5535
Phone(706) 521-0550
Organization SubpartNo
Authorized OfficialCharles E TrefzgerManager · (828) 322-5535
Enumeration DateJanuary 4, 2023
NPPES CertifiedJanuary 4, 2023
✔ NPI 1053024174 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAssisted Living FacilityNursing & Custodial Care Facilities
Taxonomy Code310400000X
Definition
A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.
2040 RESURGENCE DR, Watkinsville, GA 30677
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Other Names 1

Doing Business AsSt Gabriel Of Athens

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 11D2233356

Watkinsville 2040, LLC Dba Hearthwood At Athens · Watkinsville, GA
Active · expires May 10, 2028
CLIA Number11D2233356
Laboratory TypeAssisted Living Facility
Certificate Effective DateMay 11, 2026
Certificate Expiration DateMay 10, 2028
Laboratory DirectorDaphne Francis
Laboratory Phone(706) 715-5532
Laboratory LocationWatkinsville 2040, LLC Dba Hearthwood At Athens2040 Resurgence Drive, Watkinsville, GA 30677
CLIA data matches this NPI record on: Address
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Watkinsville Opco LLC's NPI number?

The NPI number for Watkinsville Opco LLC is 1053024174. It was assigned to this organization in the NPPES registry on January 4, 2023. The provider is doing business as St Gabriel of Athens.

Where is Watkinsville Opco LLC located?

Watkinsville Opco LLC is located at 2040 Resurgence Dr, Watkinsville, GA 30677. The listed phone number is (706) 521-0550.

What is Watkinsville Opco LLC's specialty?

The primary specialty registered for this NPI is Assisted Living Facility with taxonomy code 310400000X.

Does Watkinsville Opco LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 11D2233356) is associated with this NPI, valid through May 10, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Watkinsville Opco LLC was last updated on January 4, 2023. NPI Profile syncs with the weekly NPPES data releases published by CMS.