Organization Active NPI

Pruitthealth - Eastside, LLC

Doing business as PruittHealth - Eastside

  • Skilled Nursing Facility
  • Macon, GA
National Provider Identifier
1013321884
Registry record updated Apr 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
PRUITTHEALTH - EASTSIDE, LLC
Doing business as
PruittHealth - Eastside
Practice address
2795 Finney Cir
Macon, GA 31217-4512
Phone
(478) 755-1875
Fax
(478) 755-1881
NPI assigned
Jun 19, 2014
Last updated
Apr 5, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2021

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)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X NU Primary

Addresses

Primary practice location

2795 Finney Cir
Macon, GA 31217-4512

Mailing address

1626 Jeurgens CT
Legal Dept
Norcross, GA 30093-2219
Phone (770) 279-6200

Other identifiers 1

IdentifierTypeStateIssuer
000140687AMedicaidGA

Other names 1

  • PruittHealth - Eastside Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140911000006 GA Part A Provider - Skilled Nursing Facility 9739308420 Practice locations: Macon, GA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1013321884. Details of each certification follow.

Skilled nursing facility certification: CCN 115391

Legal name
PRUITTHEALTH - EASTSIDE, LLC
Doing business as
PRUITTHEALTH - EASTSIDE
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Jun 1, 1989
Last certification
Sep 22, 2024
Beds
90
Ownership / control type
Corporation
Multi-facility organization
Pruitt Health
Organization structure
LLCProprietary
Enrollment address
2795 Finney Cir
Macon, GA 31217-4512
Nursing home name
PRUITTHEALTH - EASTSIDE
Affiliated entity
PRUITTHEALTH

Care Compare: Nursing home

Medicare Care Compare
Listed as
Pruitthealth - EastsideCCN 115391 · All quality measures
Overall star rating
4 of 5
Health inspections
4 of 5
Staffing
1 of 5
Quality measures
5 of 5
Type
Medicare and Medicaid
Ownership
For profit - Corporation
Certified
Jun 1, 1989
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
9082.5 residents per day on average
Chain
Pruitthealth95 facilities in the chain

Processed by Care Compare on Aug 1, 2026.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
11D0264199Pruitthealth - Eastside, LLC2795 Finney Circle, Macon, GA 31217Certificate of waiverJul 1, 2027

National Provider Directory

National Provider Directory

Networks

  • SC HMO

Ownership & related parties

All disclosed owners & managing parties 21

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Rosewood Healthcare Properties Inc Organization, Norcross, GA Corporation Adp of the SNF Jun 5, 2014
Indirect Ownership Interest Jun 5, 2014
NWP 2020 Child TR Fbo Lisa P Hamby Organization, Norcross, GA Indirect Ownership Interest Aug 12, 2020 2.4%
United Health Services Inc Organization, Norcross, GA Corporation, Holding company 5% Or Greater Indirect Ownership Interest Jun 11, 2014 100%
Individual Adp of the SNF Nov 11, 2019
Philip W. Small Individual Corporate DirectorDirector Nov 27, 2013
Lisa P Hamby Trust Organization, Norcross, GA 5% Or Greater Indirect Ownership Interest Jun 11, 2014 26.13%
Neil Little Pruitt Individual Corporate OfficerChairman and Ceo Jun 11, 2014 100%
Direct Ownership Interest Nov 27, 2013 1%
Individual Adp of the SNF Nov 27, 2013
Neil L Pruitt Jr Trust Organization, Norcross, GA 5% Or Greater Indirect Ownership Interest Jun 11, 2014 35.2%
Adp of the SNF Nov 27, 2013
Indirect Ownership Interest Nov 27, 2013 42.86%
NWP 2020 Child TR Fbo Neil L Pruitt Jr Organization, Norcross, GA Indirect Ownership Interest Aug 12, 2020 2.4%
NWP 2020 Child TR Fbo J Paige Pruitt Organization, Norcross, GA Indirect Ownership Interest Aug 12, 2020 2.4%
Individual Adp of the SNF Nov 27, 2013
Pruitt Family Trust Organization, Norcross, GA Adp of the SNF Jan 26, 2026
Indirect Ownership Interest Aug 12, 2020 1.59%
Nancy W Pruitt Individual Corporate OfficerSecretary/Director Nov 27, 2013
Organization, Norcross, GA Adp of the SNF Jan 14, 2025
Indirect Ownership Interest Jan 14, 2025 1.59%
Ashley Goolsby Individual Operational/Managerial Control Jan 27, 2025
Adp of the SNF Mar 28, 2025
Pruitthealth Consulting Services Inc Organization, Norcross, GA Corporation Adp of the SNF Nov 26, 2013
Individual Adp of the SNF Mar 28, 2025
Uhs-Pruitt Holdings, Inc. Organization, Norcross, GA Holding company 5% Or Greater Indirect Ownership Interest Jun 11, 2014 100%
United Health Services of Georgia, Inc. Organization, Norcross, GA Corporation, Holding company 5% Or Greater Direct Ownership Interest Jun 11, 2014 99%
Direct Ownership Interest Nov 27, 2013 99%
J Paige Pruitt Trust Organization, Norcross, GA 5% Or Greater Indirect Ownership Interest Jun 11, 2014 28.84%

Facilities with the same owner 123

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 123

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

Affiliated clinicians 2

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": "1403136000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1617580800000",
    "number": "1013321884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1626 JEURGENS CT",
            "address_2": "LEGAL DEPT",
            "city": "NORCROSS",
            "state": "GA",
            "postal_code": "300932219",
            "telephone_number": "770-279-6200",
            "fax_number": "770-931-5278"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2795 FINNEY CIR",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312174512",
            "telephone_number": "478-755-1875",
            "fax_number": "478-755-1881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRUITTHEALTH - EASTSIDE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-19",
        "last_updated": "2021-04-05",
        "certification_date": "2021-03-16",
        "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": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000140687A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PruittHealth - Eastside",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "PruittHealth - Eastside",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Macon, GA

Sources for this page

Verify at the official NPI Registry.