PRUITTHEALTH - AUGUSTA, LLC (NPI# 1295908846) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295908846 |
| Entity Type | Organization |
| Organization Name | PRUITTHEALTH - AUGUSTA, LLC |
| Other Organization Name | PRUITTHEALTH - AUGUSTA |
| Practice Address |
2541 Milledgeville Road Augusta GA 30904-4954 |
| Mailing Address |
1626 Jeurgens Ct Norcross GA 30093-2219 |
| Practice Telephone | 7067382581 |
| Practice Fax Number | 7067385235 |
| Mailing Telephone | 7702796200 |
| Mailing Fax Number | 7709254619 |
| Enumeration Date | 2008-04-03 |
| Last Update Date | 2014-04-23 |
| 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 | 1-121-1724 | GA | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 000059463A | 05 |
| Other Name | Type Code |
|---|---|
| PruittHealth - Augusta | Doing Business As Name - Organization |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | PRUITTHEALTH - AUGUSTA, LLC | 2541 Milledgeville Rd, Augusta, GA 30904-4954 |
| Street Address |
2541 MILLEDGEVILLE ROAD |
| City | AUGUSTA |
| State | GA |
| Zip Code | 30904-4954 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518423706 | Lawren Murray Tachias | Registered Nurse | 950 15th Street Downtown, Augusta, GA 30904 | 2019-02-13 |
| 1457851842 | Heba Ahmed | Pharmacist | 912 15th Street, Augusta, GA 30904 | 2018-02-13 |
| 1124552690 | Jenny Liles | Student in an Organized Health Care Education/Training Program | 1004 Chafee Ave, Augusta, GA 30904 | 2017-04-11 |
| 1932640836 | Claudia Crawford | Student in an Organized Health Care Education/Training Program | 2624 Oakland Ave., Augusta, GA 30904 | 2017-03-13 |
| 1801240528 | F. Marion Durst IIi Dmd PC | Clinic/Center | 2325 Washington Road, Augusta, GA 30904 | 2016-04-19 |
| 1689031296 | Teresa Maria Martin | Counselor | 1e-148, Charlie Norwood Vamc One Freedom Way, Augusta, GA 30904 | 2016-01-27 |
| 1598122269 | Jillian Wilkerson | Counselor | Charlie Norwood Veteran Affairs One Freedom Way, Substance Use Recovery Clinic, Augusta, GA 30904 | 2016-01-26 |
| 1760855241 | Chase King | Occupational Therapist | 1735 Berkeley Rd, Augusta, GA 30904 | 2015-11-05 |
| 1962832246 | April Underwood Fox | Physician Assistant | 1417 Pendleton Rd, Augusta, GA 30904 | 2013-11-22 |
| 1861734378 | John Graham Theisen | Obstetrics & Gynecology | 810 Chafee Avenue, Augusta, GA 30904 | 2013-03-22 |
| Find all providers in zip 30904 | ||||
| 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 |
|---|---|---|---|---|
| 1831580364 | Harrington Park Health & Rehabilitation, LLC | Skilled Nursing Facility | 511 Pleasant Home Rd, Augusta, GA 30907-3525 | 2015-02-05 |
| 1720282569 | The Place At Augusta, Inc. | Skilled Nursing Facility | 2 George C Wilson Ct, Augusta, GA 30909-6593 | 2007-06-14 |
| 1992910350 | Nephrology Center of South Augusta | Skilled Nursing Facility | 1631 Gordon Hwy Ste 1-b, Augusta, GA 30906-2221 | 2007-05-11 |
| 1225056658 | Lakepoint Augusta LLC | Skilled Nursing Facility | 901 Lakepoint Dr, Augusta, KS 67010-2423 | 2006-07-17 |
| 1609809706 | Salem Nursing & Rehab Center of Augusta, Inc. | Skilled Nursing Facility | 2021 Scott Rd, Augusta, GA 30906-2539 | 2006-07-09 |
| 1376572073 | The Place At Deans Bridge, LLC | Skilled Nursing Facility | 3235 Deans Bridge Rd, Augusta, GA 30906-7004 | 2006-07-03 |
| 1235186974 | Pruitthealth - Augusta Hills LLC | Skilled Nursing Facility | 2122 Cumming Rd, Augusta, GA 30904-4334 | 2006-05-28 |
| 1598717753 | Ggnsc Augusta II LLC | Skilled Nursing Facility | 1600 Anthony Rd, Augusta, GA 30904-4824 | 2006-05-16 |
| 1245282409 | Ggnsc Augusta Windermere LLC | Skilled Nursing Facility | 3618 J Dewey Gray Cir, Augusta, GA 30909-1867 | 2006-05-16 |
| 1508822305 | University Extended Care, Inc | Skilled Nursing Facility | 1227 W Wheeler Pkwy, Augusta, GA 30909-1899 | 2006-04-21 |
| Find all providers in AUGUSTA | ||||
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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.