PRUITTHEALTH - VALDOSTA, LLC (NPI# 1770107914) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770107914 |
| Entity Type | Organization |
| Organization Name | PRUITTHEALTH - VALDOSTA, LLC |
| Practice Address |
2501 N Ashley St Valdosta GA 31602-1820 |
| Mailing Address |
1626 Jeurgens Court Legal Dept Norcross GA 30093 |
| Practice Telephone | 2292447368 |
| Mailing Telephone | 7702796200 |
| Enumeration Date | 2020-06-03 |
| Last Update Date | 2020-06-03 |
| 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 | 314000000X | Skilled Nursing Facility | Nursing & Custodial Care Facilities |
| Street Address |
2501 N ASHLEY ST |
| City | VALDOSTA |
| State | GA |
| Zip Code | 31602-1820 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942257464 | Lowndes County Health Services, LLC | Skilled Nursing Facility | 2501 N Ashley St, Valdosta, GA 31602-1820 | 2006-05-29 |
| 1821509241 | Miranda Fitzpatrick | Registered Nurse | 2501 N Ashley St, Valdosta, GA 31602 | 2017-10-12 |
| 1861700064 | United Rehab Inc. | Clinic/Center | 2501 N Ashley St, Valdosta, GA 31602-1820 | 2010-09-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477198117 | Amber Michele Baugh | Behavior Technician | 2236 Bemiss Road, Valdosta, GA 31602 | 2019-11-15 |
| 1528611365 | Nishaben T. Patel | Nurse Practitioner | 3120 North Oak Street Extension, Suite B, Valdosta, GA 31602 | 2019-07-22 |
| 1427615871 | Blair Elizabeth Tomlinson | Nurse Practitioner | 2124 Lakeshore Drive, Valdosta, GA 31602 | 2019-05-21 |
| 1346704152 | Mildred Itaska Borowski | Counselor | 3790 North Highway 41, Suite A, Valdosta, GA 31602 | 2019-01-25 |
| 1962991703 | Southern Healthcare Alliance, LLC | Physical Medicine & Rehabilitation | 101-f W. Northside Drive, Valdosta, GA 31602 | 2018-05-08 |
| 1336636646 | Kaitlyn Thrift | Behavioral Analyst | 2225 Bemiss Road Suite D, Valdosta, GA 31602 | 2018-04-23 |
| 1407379845 | Lindsey Marie Richardson | Dentist | 103 W. Cranford Ave, Valdosta, GA 31602 | 2017-07-18 |
| 1962922427 | Taylor Nicole Fiveash | Nurse Practitioner | 101 W Northisde Dr, Bldg G, Valdosta, GA 31602 | 2017-06-26 |
| 1720520646 | Southern Sleepers Anesthesia LLC | Nurse Anesthetist, Certified Registered | 4120-b N. Valdosta Road, Valdosta, GA 31602 | 2016-11-09 |
| 1134670557 | Cataract and Laser Surgery Center of South Georgia, P.C. | Clinic/Center | 4120-b N. Valdosta Rd., Valdosta, GA 31602 | 2016-10-20 |
| Find all providers in zip 31602 | ||||
| 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 |
|---|---|---|---|---|
| 1568401578 | Lowndes County Health Services, LLC | Skilled Nursing Facility | 410 Northside Dr, Valdosta, GA 31602-1802 | 2006-06-05 |
| 1659310662 | Lowndes County Health Services, LLC | Skilled Nursing Facility | 413 Pendleton Pl, Valdosta, GA 31602-2632 | 2006-06-05 |
| 1295774222 | Lowndes County Health Services LLC | Skilled Nursing Facility | 415 Pendleton Pl, Valdosta, GA 31602-2632 | 2006-06-05 |
| 1942257464 | Lowndes County Health Services, LLC | Skilled Nursing Facility | 2501 N Ashley St, Valdosta, GA 31602-1820 | 2006-05-29 |
| 1861016008 | Pruitthealth - Parkwood, LLC | Skilled Nursing Facility | 1501 N Lee St, Valdosta, GA 31602-3309 | 2020-06-03 |
| 1063036200 | Pruitthealth - Crestwood, LLC | Skilled Nursing Facility | 415 Pendleton Pl, Valdosta, GA 31602-2632 | 2020-06-03 |
| 1972127116 | Pruitthealth - Holly Hill, LLC | Skilled Nursing Facility | 413 Pendleton Pl, Valdosta, GA 31602-2632 | 2020-06-03 |
| 1881218022 | Pruitthealth - Lakehaven, LLC | Skilled Nursing Facility | 410 Northside Dr, Valdosta, GA 31602-1802 | 2020-06-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689281982 | Georgia Regional Health Services LLC | Skilled Nursing Facility | 3731 Lake Pass Ln, Suwanee, GA 30024-8422 | 2020-09-30 |
| 1124633268 | Lavender Mountain Senior Living Inc | Skilled Nursing Facility | 600 Eagle Lake Trl, Rome, GA 30165-2207 | 2020-09-15 |
| 1215550264 | Mesun Health Services, Inc | Skilled Nursing Facility | 88 Johnson Rd. Building #2, Lawrenceville, GA 30046 | 2020-05-26 |
| 1255966081 | Westminster Presbyterian Homes, Inc. | Skilled Nursing Facility | 1400 Live Oak Ln, Building 100, Athens, GA 30606 | 2020-03-12 |
| 1205486859 | Magnolia Manor of Liberty County, Inc. | Skilled Nursing Facility | 625 N Coastal Hwy # 17, Midway, GA 31320-3433 | 2019-09-16 |
| 1497301170 | Prestige Health Services LLC | Skilled Nursing Facility | 1770 Indian Trail Lilburn Rd Ste 420, Norcross, GA 30093-2644 | 2019-08-17 |
| 1043878721 | Keysville Ltc Management LLC | Skilled Nursing Facility | 1005 Ga Highway 88, Blythe, GA 30805-3911 | 2019-05-29 |
| 1689131724 | Favor Home Health Care Services, LLC | Skilled Nursing Facility | 51 Gallery Ct, Acworth, GA 30101-2709 | 2019-02-25 |
| 1104398866 | University Extended Care, Inc | Skilled Nursing Facility | 1005 Highway 88 N, Keysville, GA 30816 | 2018-12-19 |
| 1548745342 | Gacalhoun Snf LLC | Skilled Nursing Facility | 1387 Highway 41 N., Calhoun, GA 30701 | 2018-09-27 |
| Find all providers with the same taxonomy | ||||
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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.