Active NPI
Pruitthealth - Panama City, LLC
Doing business as PruittHealth - Panama City
- Skilled Nursing Facility
- Panama City, FL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- Legal business name
- PRUITTHEALTH - PANAMA CITY, LLC
- Doing business as
- PruittHealth - Panama City
- Practice address
- 3212 Jenks Ave
Panama City, FL 32405-4224 - Phone
- (850) 771-1521
- Fax
- (850) 771-1522
- NPI assigned
- Jul 2, 2018
- Last updated
- Nov 9, 2018
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Neil L. Pruitt Jr.
- Title
- Chairman and Ceo of Manager
- Phone
- (770) 279-6200
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | NU | Primary |
Addresses
Primary practice location
3212 Jenks Ave
Panama City, FL 32405-4224
Mailing address
1626 Jeurgens CT
Norcross, GA 30093-2219
Phone (770) 279-6200
Other names 1
- PruittHealth - Panama City
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20181101000798 | FL | Part A Provider - Skilled Nursing Facility | 0446503817 | Practice locations: Panama City, FL |
NPI to CCN mapping 1
The Medicare certification numbers (CCNs) connected to NPI 1003302027. Details of each certification follow.
Skilled nursing facility certification: CCN 106121
- Legal name
- PRUITTHEALTH - PANAMA CITY, LLC
- Doing business as
- PRUITTHEALTH - PANAMA CITY
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Jan 31, 2019
- Last certification
- Apr 9, 2025
- Beds
- 101
- Ownership / control type
- Individual
- Multi-facility organization
- Pruitthealth Corperation
- Organization structure
- LLC
- Incorporated
- Oct 16, 2017 in FL
- Enrollment address
- 3212 Jenks Ave
Panama City, FL 32405-4224 - Nursing home name
- PRUITTHEALTH - PANAMA CITY
- Affiliated entity
- PRUITTHEALTH
Care Compare: Nursing home
Medicare Care Compare- Listed as
- Pruitthealth - Panama City
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- For profit - Individual
- Certified
- Jan 31, 2019
- Medicare certification status
- Active
- Certified beds
- 101
- Chain
- Pruitthealth
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 10D2157937 | Pruitthealth - Panama City | Certificate of waiver | Nov 15, 2026 |
National Provider Directory
National Provider DirectoryOwnership & related parties
All disclosed owners & managing parties 14
As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.
| Name | Role | Since | Share |
|---|---|---|---|
| United Health Services Inc | 5% Or Greater Indirect Ownership Interest | Oct 16, 2014 | 100% |
| Renee Hamilton | W-2 Managing Employee | Dec 27, 2021 | 100% |
| Charles Jackson | W-2 Managing Employee | Oct 15, 2021 | 100% |
| Pruitthealth Inc | Other | Oct 16, 2014 | |
| Pruitthealth - Northwest Florida LLC | 5% Or Greater Direct Ownership Interest | Oct 16, 2014 | 99% |
| Louise Merrick | W-2 Managing Employee | Jul 15, 2021 | 100% |
| United Health Services of Florida, Inc | 5% Or Greater Indirect Ownership Interest | Oct 16, 2014 | 100% |
| Lisa P Hamby Trust | 5% Or Greater Indirect Ownership Interest | Oct 16, 2014 | 26.13% |
| Neil Little Pruitt | Corporate Officer | Oct 16, 2014 | 100% |
| Corporate Director | Oct 16, 2014 | 100% | |
| Other | Oct 16, 2014 | 100% | |
| Neil L Pruitt Jr Trust | 5% Or Greater Indirect Ownership Interest | Oct 16, 2014 | 35.2% |
| Amanda S Wray | W-2 Managing Employee | Mar 30, 2020 | 100% |
| Scott Bell | W-2 Managing Employee | Feb 9, 2020 | 100% |
| Uhs-Pruitt Holdings, Inc. | 5% Or Greater Indirect Ownership Interest | Oct 16, 2014 | 100% |
| J Paige Pruitt Trust | 5% Or Greater Indirect Ownership Interest | Oct 16, 2014 | 28.84% |
Facilities with the same owner 122
Facilities that share an organizational owner with 5% or greater ownership or operational control.
-
dba PruittHealth - Fleming Island
- Skilled Nursing Facility
- Fleming Island, FL
- NPI 1649758012
J Paige Pruitt Trust, Lisa P Hamby Trust, Neil L Pruitt Jr Trust, Uhs-Pruitt Holdings, Inc., United Health Services Inc, United Health Services of Florida, Inc
-
- Skilled Nursing Facility
- Lutz, FL
- NPI 1821705237
Uhs-Pruitt Holdings, Inc., United Health Services Inc, United Health Services of Florida, Inc
-
- Skilled Nursing Facility
- Pensacola, FL
- NPI 1659136075
J Paige Pruitt Trust
-
dba PruittHealth - Santa Rosa
- Skilled Nursing Facility
- Milton, FL
- NPI 1316992605
J Paige Pruitt Trust, Lisa P Hamby Trust, Neil L Pruitt Jr Trust, Uhs-Pruitt Holdings, Inc., United Health Services Inc, United Health Services of Florida, Inc
-
dba PruittHealth - SouthWood
- Skilled Nursing Facility
- Tallahassee, FL
- NPI 1053944116
J Paige Pruitt Trust, Lisa P Hamby Trust, Neil L Pruitt Jr Trust, United Health Services Inc, United Health Services of Florida, Inc
-
dba PruittHealth @ Home Jacksonville
- Home Health Agency
- Jacksonville, FL
- NPI 1922718774
Uhs-Pruitt Holdings, Inc., United Health Services Inc
-
dba PruittHealth - Aiken
- Skilled Nursing Facility
- Aiken, SC
- NPI 1679786917
J Paige Pruitt Trust, Uhs-Pruitt Holdings, Inc., United Health Services Inc
-
dba PruittHealth - Ashburn
- Skilled Nursing Facility
- Ashburn, GA
- NPI 1851347108
J Paige Pruitt Trust, Lisa P Hamby Trust, Neil L Pruitt Jr Trust, Uhs-Pruitt Holdings, Inc., United Health Services Inc
-
dba PruittHealth - Athens Heritage
- Skilled Nursing Facility
- Athens, GA
- NPI 1316993769
J Paige Pruitt Trust, Lisa P Hamby Trust
-
dba PruittHealth - Augusta Hills
- Skilled Nursing Facility
- Augusta, GA
- NPI 1235186974
United Health Services Inc
-
dba PruittHealth - Augusta
- Skilled Nursing Facility
- Augusta, GA
- NPI 1295908846
J Paige Pruitt Trust, Lisa P Hamby Trust, Neil L Pruitt Jr Trust, Uhs-Pruitt Holdings, Inc., United Health Services Inc
-
dba PruittHealth - Austell
- Skilled Nursing Facility
- Austell, GA
- NPI 1386690642
J Paige Pruitt Trust, Lisa P Hamby Trust, Neil L Pruitt Jr Trust, Uhs-Pruitt Holdings, Inc., United Health Services Inc
Practitioners & affiliated clinicians
Affiliated clinicians 7
Clinicians who list this facility as an affiliation in Medicare Care Compare.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1530489600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1541721600000",
"number": "1003302027",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1626 JEURGENS CT",
"city": "NORCROSS",
"state": "GA",
"postal_code": "300932219",
"telephone_number": "770-279-6200"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3212 JENKS AVE",
"city": "PANAMA CITY",
"state": "FL",
"postal_code": "324054224",
"telephone_number": "850-771-1521",
"fax_number": "850-771-1522"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PRUITTHEALTH - PANAMA CITY, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2018-07-02",
"last_updated": "2018-11-09",
"status": "A",
"authorized_official_last_name": "PRUITT",
"authorized_official_first_name": "NEIL",
"authorized_official_middle_name": "L.",
"authorized_official_title_or_position": "CHAIRMAN AND CEO OF MANAGER",
"authorized_official_telephone_number": "770-279-6200",
"authorized_official_name_suffix": "Jr."
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "PruittHealth - Panama City",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Panama City, FL
- Prosper Functional Health LLC
- Providence Medical Transportation LLC
- Linda P Prowse
- Bryan Pruess, ARNP
- Heather Jean Pruett, COTA/L
- Marta Lucia Prupas, FNP
- Publix Super Markets Inc (Publix Pharmacy #0481)
- Publix Super Markets, Inc. (Publix Pharmacy #2034)
- Publix Super Markets, Inc. (Publix Pharmacy #1875)
- Virginia K Pullen, PA-C
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.