PRUITTHEALTH HOME HEALTH - SOUTH ATLANTA, INC. (NPI# 1245278407) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245278407 |
| Entity Type | Organization |
| Organization Name | PRUITTHEALTH HOME HEALTH - SOUTH ATLANTA, INC. |
| Other Organization Name | PRUITTHEALTH @ HOME - GRIFFIN |
| Practice Address |
147 W Ellis Rd Suites B & C Griffin GA 30223-7147 |
| Mailing Address |
1626 Jeurgens Ct Norcross GA 30093-2219 |
| Practice Telephone | 7702280525 |
| Practice Fax Number | 7702280894 |
| Mailing Telephone | 7702796200 |
| Mailing Fax Number | 7709315278 |
| Enumeration Date | 2006-06-02 |
| Last Update Date | 2019-02-22 |
| Authorized Official Name | NEIL L PRUITT JR. (CHAIRMAN AND CEO) |
| Authorized Official Telephone | 7702796200 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251E00000X | Home Health | 126-283-H | GA | Agencies |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 00709816A | 05 |
| Other Name | Type Code |
|---|---|
| PruittHealth @ Home - Griffin | Doing Business As Name - Organization |
| PruittHealth Home Health - Griffin | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942248331 | Pruitthealth Home Health - South Atlanta, Inc. | Home Health | 7345 Red Oak Road, Building 25, Union City, GA 30291-2391 | 2006-06-04 |
| Street Address |
147 W ELLIS RD SUITES B & C |
| City | GRIFFIN |
| State | GA |
| Zip Code | 30223-7147 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235783036 | Jennifer Lashawn Stevenson | Registered Nurse | 1071 Highway 16 West, Griffin, GA 30223 | 2019-07-30 |
| 1992357644 | Nikki Petty | Behavior Technician | 185 Grady Street, Griffin, GA 30223 | 2019-07-12 |
| 1568940146 | Brenda Pope | Counselor | 1710 Highway 16 West, Griffin, GA 30223 | 2018-08-05 |
| 1073025151 | Vonita Clowers | Specialist | 1424 N. Expy, Suite 115, Griffin, GA 30223 | 2017-10-30 |
| 1912427592 | Sheena Murphy | Registered Nurse | 109 N. 10th Street, Griffin, GA 30223 | 2017-06-23 |
| 1033639612 | Taralyn Rae Sams | Registered Nurse | 109 North 10th Street, Griffin, GA 30223 | 2017-06-23 |
| 1326594656 | Wendell Robinson | Registered Nurse | 109 N.10th Street, Griffin, GA 30223 | 2016-08-28 |
| 1508235466 | Trenisha Jones Mccall | Counselor | 1815 North Expressway, Griffin, GA 30223 | 2015-09-22 |
| 1104224948 | Dawn Tyus | Counselor | 424 W. Taylor Street, Griffin, GA 30223 | 2014-12-10 |
| 1003173030 | Ingles Markets Inc | Pharmacy | 1735 Zebulon Rd, Griffin, GA 30223 | 2012-04-16 |
| Find all providers in zip 30223 | ||||
| Taxonomy Code | 251E00000X |
| Grouping | Agencies |
| Classification | Home Health |
| A public agency or private organization, or a subdivision of such an agency or organization, that is primarily engaged in providing skilled nursing services and other therapeutic services, such as physical therapy, speech-language pathology services, or occupational therapy, medical social services, and home health aide services. It has policies established by a professional group associated with the agency or organization (including at least one physician and one registered nurse) to govern the services and provides for supervision of such services by a physician or a registered nurse; maintains clinical records on all patients; is licensed in accordance with State or local law or is approved by the State or local licensing agency as meeting the licensing standards, where applicable; and meets other conditions found by the Secretary of Health and Human Services to be necessary for health and safety. |
| Notes: Source: CFR42 Chapter IV Part 484, http://www.access.gpo.gov/nara/cfr/waisidx_99/42cfr484_99.html [7/1/2007: definition added, source added] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740804723 | Arnisha Smith Newton | Home Health | 1560 Flynt St Apt C1, Griffin, GA 30223-2084 | 2020-06-04 |
| 1871135046 | Gem Care Inc | Home Health | 625 W Taylor St Ste 600, Griffin, GA 30223-2704 | 2019-10-09 |
| 1962822817 | Roshanda Puckett | Home Health | 1309 Greenview Dr, Griffin, GA 30224-4048 | 2014-04-18 |
| 1093130734 | Vital Hearts Htc LLC | Home Health | 424 W Taylor St, Griffin, GA 30223-2818 | 2014-03-04 |
| 1427370311 | Qualitee Care | Home Health | 217 Quincy Avenue, Apt 1, Griffin, GA 30223 | 2010-02-19 |
| 1366587438 | Southern Regional Medical Center Inc | Home Health | 224 E College St, Griffin, GA 30224-4348 | 2007-02-20 |
| 1275686586 | Homenurse Inc. | Home Health | 2920 N Expressway, Griffin, GA 30223-6495 | 2007-01-19 |
| 1336197003 | Amedisys Northwest, L.L.C. | Home Health | 244 Odell Rd, Unit 1, Griffin, GA 30224-4787 | 2006-05-05 |
| 1598804536 | Prn Pool Inc | Home Health | 240 Odell Rd, Griffin, GA 30224-4787 | 2007-02-06 |
| 1063563112 | Prn Pool Inc | Home Health | 240 Odell Rd, Griffin, GA 30224-4787 | 2007-01-16 |
| Find all providers in GRIFFIN | ||||
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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.