PRUITTHEALTH - VIRGINIA PARK, LLC (NPI# 1134500754) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134500754 |
| Entity Type | Organization |
| Organization Name | PRUITTHEALTH - VIRGINIA PARK, LLC |
| Other Organization Name | PRUITTHEALTH - VIRGINIA PARK |
| Practice Address |
1000 Briarcliff Rd Ne Atlanta GA 30306-2618 |
| Mailing Address |
1626 Jeurgens Ct Norcross GA 30093-2219 |
| Practice Telephone | 4048756456 |
| Practice Fax Number | 4048744606 |
| Mailing Telephone | 7702796200 |
| Mailing Fax Number | 7709315278 |
| Enumeration Date | 2015-06-10 |
| Last Update Date | 2015-06-10 |
| Authorized Official Name | NEIL L. PRUITT JR. (CHAIRMAN AND CEO OF MANAGER) |
| Authorized Official Telephone | 7702796200 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 000140401A | 05 |
| Other Name | Type Code |
|---|---|
| PruittHealth - Virginia Park | Doing Business As Name - Organization |
| Street Address |
1000 BRIARCLIFF RD NE |
| City | ATLANTA |
| State | GA |
| Zip Code | 30306-2618 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831125129 | Sharri Khay Rittenhouse | Nurse Practitioner | 1000 Briarcliff Rd Ne, Atlanta, GA 30306-2618 | 2006-06-25 |
| 1437634417 | Iyabo O Otekunrin | Nutritionist | 1000 Briarcliff Rd Ne, Atlanta, GA 30306-2618 | 2018-09-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750900858 | Jill Driver | Chiropractor | 1390 Lanier Blvd Ne, 1409-a, Atlanta, GA 30306 | 2020-04-09 |
| 1447737697 | Heather Nicole Vansau | Speech-Language Pathologist | 1272 Stillwood Dr Ne, Atlanta, GA 30306 | 2018-07-20 |
| 1871095919 | Michelle Ruth Orovitz | Nurse Practitioner | 1140 Briarcliff Rd Ne Apt 1, Atlanta, GA 30306 | 2018-03-05 |
| 1497261960 | Rockwell Oral and Facial Surgery LLC | Dentist | 675 N. Highland Ave Ne, Suite 100, Atlanta, GA 30306 | 2017-12-20 |
| 1518414101 | David Alan Sturgess Jr. | Counselor | 696 Courtenay Dr, Ne, Atlanta, GA 30306 | 2016-09-01 |
| 1952778565 | Kristen Jugs | Speech-Language Pathologist | 609 Virginia Ave Ne Apt 4108, None, Atlanta, GA 30306 | 2015-08-31 |
| 1962749655 | Robert B Tersak | Pharmacist | 1001 Ponce De Leon Avenue Ne, Atlanta, GA 30306 | 2013-01-15 |
| 1730434812 | Poonam Bhakta Hurley | Physical Therapist | 842 N Highland Ave Ne Ste Ter, Atlanta, GA 30306 | 2012-07-16 |
| 1609158963 | Centers for Disease Control and Prevention, Us Public Health Service | Public Health or Welfare | 1600 Clifton Rd, Ms E46, Atlanta, GA 30306 | 2011-09-13 |
| 1598045965 | April Kooy | Physician Assistant | 1000 Briarcliff Road Ne, Atlanta, GA 30306 | 2011-08-17 |
| Find all providers in zip 30306 | ||||
| Taxonomy Code | 314000000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Skilled Nursing Facility |
| (1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis. |
| Notes: Source: (1) "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/October 1995, p. 64; (2) AHA Guide, 1996 Annual Survey. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639619307 | Medicinal Plus | Skilled Nursing Facility | 2443 Center Pointe Cir Sw, Atlanta, GA 30315-7309 | 2017-02-28 |
| 1164972188 | Marie Rosemonde Nozil-bernadel | Skilled Nursing Facility | 3715 Northside Pkwy Nw Bldg 200, Atlanta, GA 30327-2882 | 2016-10-13 |
| 1730639022 | Dunwoody Operating Company LLC | Skilled Nursing Facility | 5470 Meridian Marks Rd Bldg E, Atlanta, GA 30342-1624 | 2016-10-11 |
| 1447668538 | Winnie-stowell Hospital District | Skilled Nursing Facility | 1104 S. William Street, Atlanta, TX 75551 | 2014-08-01 |
| 1073927018 | Winnie-stowell Hospital District | Skilled Nursing Facility | 200 Live Oak Dr, Atlanta, TX 75551-2802 | 2014-06-18 |
| 1669723987 | Tender Touch Private Home Care, LLC | Skilled Nursing Facility | 215 Hilltop Dr Sw, Atlanta, GA 30315-6019 | 2012-09-26 |
| 1811269533 | Rose Haven Healthcare LLC | Skilled Nursing Facility | 200 Live Oak St, Atlanta, TX 75551-2802 | 2012-01-27 |
| 1144509613 | Lenbrook Square Foundation, Inc. | Skilled Nursing Facility | 3747 Peachtree Rd Ne, Atlanta, GA 30319-1360 | 2011-08-15 |
| 1508160045 | Integrity Personal Care Home | Skilled Nursing Facility | 4192 Kenwood Trl, Atlanta, GA 30349-1979 | 2010-12-25 |
| 1942502364 | Partnership for Health Health Care | Skilled Nursing Facility | 905 James Jackson Pkwy Nw Ste 6, Atlanta, GA 30318-9501 | 2010-11-18 |
| Find all providers in ATLANTA | ||||
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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.