PRUITTHEALTH - MACON, LLC (NPI# 1710934237) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710934237 |
| Entity Type | Organization |
| Organization Name | PRUITTHEALTH - MACON, LLC |
| Other Organization Name | PRUITTHEALTH - MACON |
| Practice Address |
2255 Anthony Rd Macon GA 31204-5823 |
| Mailing Address |
1626 Jeurgens Ct Norcross GA 30093-2219 |
| Practice Telephone | 4787847900 |
| Mailing Telephone | 7702796200 |
| Enumeration Date | 2006-05-29 |
| Last Update Date | 2014-07-02 |
| 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 | 1-011-218 | GA | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 00141908A | 05 |
| Other Name | Type Code |
|---|---|
| PruittHealth - Macon | Doing Business As Name - Organization |
| Street Address |
2255 ANTHONY RD |
| City | MACON |
| State | GA |
| Zip Code | 31204-5823 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306349899 | Villanueva Topaze Spivey | Nurse Practitioner | 2255 Anthony Rd, Macon, GA 31204-5823 | 2018-03-12 |
| 1538476064 | United Rehab Inc | Clinic/Center | 2255 Anthony Rd, Macon, GA 31204-5823 | 2010-09-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942775085 | Amy Lynn Miller | Counselor | 890 Northwoods Plaza/burrus Road, Macon, GA 31204 | 2018-10-04 |
| 1275056566 | Kenyada Moss | Counselor | 762 Thurmond Dr., Macon, GA 31204 | 2017-07-19 |
| 1508303876 | Amber Foster | Counselor | 890 Northwoods Plaza, Macon, GA 31204 | 2017-01-25 |
| 1952757585 | Sarah Vanselous Spencer | Speech-Language Pathologist | 2720 Sheraton Dr # D-140, Macon, GA 31204 | 2016-05-12 |
| 1952706343 | Matthew Wayne Frazier | Pharmacist | 4260 Log Cabin Dr, Macon, GA 31204 | 2014-10-28 |
| 1215338587 | Sharon Yvette Flewellen | Licensed Practical Nurse | 1876 Moore Street, Macon, GA 31204 | 2014-09-05 |
| 1336565647 | Accel Wellness Center, LLC | Specialist | 3083 Vineville Avenue, Macon, GA 31204 | 2014-03-11 |
| 1821439811 | Irene Gung Ho | Physician Assistant | 3203 Vineville Ave Ste A, Macon, GA 31204 | 2013-07-08 |
| 1518125657 | Jennifer Burns | Marriage & Family Therapist | 116 Pierce Avenue, Macon, GA 31204 | 2008-05-27 |
| 1255599346 | Methodist Home of The South Georgia Conference, Inc. | Voluntary or Charitable | 304 Pierce Avenue, Macon, GA 31204 | 2008-05-27 |
| Find all providers in zip 31204 | ||||
| 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 |
|---|---|---|---|---|
| 1013321884 | Pruitthealth - Eastside, LLC | Skilled Nursing Facility | 2795 Finney Cir, Macon, GA 31217-4512 | 2014-06-19 |
| 1982963682 | Zebulon Park Health and Rehabilitation LLC | Skilled Nursing Facility | 343 Plantation Way, Macon, GA 31210 | 2012-05-15 |
| 1306060439 | Middle Georgia Life Care Inc. | Skilled Nursing Facility | 400 Foster Road, Macon, GA 31210 | 2007-04-12 |
| 1740341312 | Porter Field Health & Rehab Center LLC | Skilled Nursing Facility | 3051 Whiteside Rd, Macon, GA 31216-6209 | 2006-12-13 |
| 1649340167 | Goodwill Nursing Home, Inc | Skilled Nursing Facility | 4373 Houston Ave, Macon, GA 31206-2760 | 2006-11-09 |
| 1962437517 | Medical Management of Macon, Inc. | Skilled Nursing Facility | 29612 Kellogg Ave, Macon, MO 63552-3702 | 2006-07-12 |
| 1992741995 | Monroe County Nursing Home LLC | Skilled Nursing Facility | 529 Bolingreen Dr, Macon, GA 31210-5303 | 2006-06-20 |
| 1487699831 | Bibb County Health Care LLC | Skilled Nursing Facility | 3468 Napier Ave, Macon, GA 31204-3743 | 2006-06-19 |
| 1740227164 | Cherry Blossom Health Care Center LLC | Skilled Nursing Facility | 3520 Kenneth Dr, Macon, GA 31206-3824 | 2006-06-02 |
| 1093762510 | Pruitthealth - Peake, LLC | Skilled Nursing Facility | 6190 Peake Rd, Macon, GA 31220-3956 | 2006-05-29 |
| Find all providers in MACON | ||||
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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.