NPIMap

Organization Active NPI

Pruitthealth Hospice, Inc

Doing business as PruittHealth Hospice - Swainsboro

  • Community Based Hospice Care Agency
  • Swainsboro, GA
National Provider Identifier
1013955749
Registry record updated Apr 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
Legal business name
PRUITTHEALTH HOSPICE, INC
Doing business as
PruittHealth Hospice - Swainsboro
Practice address
667 South Main Street
Swainsboro, GA 30401-4818
Phone
(478) 237-7798
Fax
(478) 237-6670
NPI assigned
Jun 3, 2006
Last updated
Apr 7, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 7, 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
Phone
(770) 279-6200

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X NU Primary

Addresses

Primary practice location

667 South Main Street
Swainsboro, GA 30401-4818

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
00849505AMedicaidGA

Other names 1

  • PruittHealth Hospice - Swainsboro Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20070829000008 GA Part A Provider - Hospice 2264344217 1 other NPI on this enrollment
Practice locations: Savannah, GA; Swainsboro, GA
O20190702003113 GA Part B Supplier - Clinic/Group Practice 2264344217 Receives reassigned benefits from 45 practitioners
12 other NPIs on this enrollment
Practice locations: Watkinsville, GA; Augusta, GA; Valdosta, GA; Union City, GA; Swainsboro, GA; Savannah, GA; Rome, GA; Macon, GA…

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1013955749. Details of each certification follow.

Hospice certification: CCN 111572

Legal name
PRUITTHEALTH HOSPICE INC
Doing business as
PRUITTHEALTH HOSPICE- SWAINSBORO
Certification status
Active
Provider type (POS)
Hospice
Participating since
Feb 16, 1999
Last certification
Jun 8, 2022
Ownership / control type
Proprietary - Corporation
Organization structure
CorporationProprietary
Incorporated
Oct 14, 1993 in GA
Enrollment address
667 S Main St
Swainsboro, GA 30401-4818

Other NPIs with the same Medicare PAC ID 17

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

View all 17

Other NPIs on the same Medicare enrollment 12

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Care Compare: Hospice

Medicare Care Compare
Listed as
Pruitthealth Hospice-SwainsboroCCN 111572 · All quality measures
Ownership
For-Profit
Certified
Feb 16, 1999
Medicare certification status
ActiveFrom the Provider of Services file

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
11D1041162Pruitthealth Hospice- Swainsboro, LLC667 South Main Street, Swainsboro, GA 30401Certificate of waiverMay 24, 2027

National Provider Directory

National Provider Directory
Tax ID family
Pruitthealth Hospice Inc26 organizations share this tax ID, including this one

Other organizations with this tax ID 25

Organizations that report the same tax identification number in the National Provider Directory.

View all 25

Locations

6060 Lakeside Commons Dr
Macon, GA 31210
Phone (478) 745-9204

Ownership & related parties

All disclosed owners & managing parties 12

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

NameRoleSinceShare
United Health Services Inc Organization, Norcross, GA For-profit 5% Or Greater Indirect Ownership Interest Jan 2, 2006 100%
Jennifer Webb Individual W-2 Managing EmployeeAdministrator Jul 14, 2008
Philip W. Small Individual Corporate DirectorDirector Sep 17, 2013
Pruitthealth Inc Organization, Norcross, GA Corporation, For-profit 5% Or Greater Direct Ownership Interest Jan 1, 2022
Other Feb 23, 2007
Lisa P Hamby Trust Organization, Norcross, GA 5% Or Greater Indirect Ownership Interest Jan 2, 2006 28.84%
Neil Little Pruitt Individual Corporate OfficerChairman and Ceo Jan 2, 2006
Corporate DirectorDirector Feb 23, 2007
OtherChain Home Office Admin, Ao Feb 23, 2007
Neil L Pruitt Jr Trust Organization, Norcross, GA 5% Or Greater Indirect Ownership Interest Jan 2, 2006 35.2%
Nancy W Pruitt Individual Corporate OfficerSecretary Jan 2, 2006
Uhs-Pruitt Holdings, Inc. Organization, Norcross, GA For-profit 5% Or Greater Indirect Ownership Interest Jan 2, 2006 100%
Thomas R Beddingfield Individual Corporate DirectorDirector Sep 17, 2013
United Health Services of Georgia, Inc. Organization, Norcross, GA Corporation, For-profit 5% Or Greater Direct Ownership Interest Oct 31, 2003 100%
J Paige Pruitt Trust Organization, Norcross, GA 5% Or Greater Indirect Ownership Interest Jan 2, 2006 26.13%

Facilities with the same owner 123

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

  • Pruitthealth - Ashburn LLC

    dba PruittHealth - Ashburn

    • Skilled Nursing Facility
    • Ashburn, GA
    • NPI 1851347108

    J Paige Pruitt Trust, Lisa P Hamby Trust, Neil L Pruitt Jr Trust, Pruitthealth Inc, Uhs-Pruitt Holdings, Inc., United Health Services Inc, United Health Services of Georgia, Inc.

    CMS ownership
  • Pruitthealth - Athens Heritage LLC

    dba PruittHealth - Athens Heritage

    • Skilled Nursing Facility
    • Athens, GA
    • NPI 1316993769

    J Paige Pruitt Trust, Lisa P Hamby Trust

    CMS ownership
  • Pruitthealth - Augusta Hills LLC

    dba PruittHealth - Augusta Hills

    • Skilled Nursing Facility
    • Augusta, GA
    • NPI 1235186974

    United Health Services Inc

    CMS ownership
  • Pruitthealth - Augusta, LLC

    dba PruittHealth - Augusta

    • Skilled Nursing Facility
    • Augusta, GA
    • NPI 1295908846

    J Paige Pruitt Trust, Lisa P Hamby Trust, Neil L Pruitt Jr Trust, Pruitthealth Inc, Uhs-Pruitt Holdings, Inc., United Health Services Inc, United Health Services of Georgia, Inc.

    CMS ownership
  • Pruitthealth - Austell, LLC

    dba PruittHealth - Austell

    • Skilled Nursing Facility
    • Austell, GA
    • NPI 1386690642

    J Paige Pruitt Trust, Lisa P Hamby Trust, Neil L Pruitt Jr Trust, Pruitthealth Inc, Uhs-Pruitt Holdings, Inc., United Health Services Inc, United Health Services of Georgia, Inc.

    CMS ownership
  • Pruitthealth - Bethany, LLC

    dba PruittHealth - Bethany

    • Skilled Nursing Facility
    • Millen, GA
    • NPI 1184924458

    J Paige Pruitt Trust, Lisa P Hamby Trust, Neil L Pruitt Jr Trust, Pruitthealth Inc, Uhs-Pruitt Holdings, Inc., United Health Services Inc, United Health Services of Georgia, Inc.

    CMS ownership
  • Pruitthealth - Blue Ridge, LLC

    dba PruittHealth - Blue Ridge

    • Skilled Nursing Facility
    • Blue Ridge, GA
    • NPI 1730136599

    Neil L Pruitt Jr Trust, United Health Services Inc, United Health Services of Georgia, Inc.

    CMS ownership
  • Pruitthealth - Brookhaven, LLC

    dba PruittHealth - Brookhaven

    • Skilled Nursing Facility
    • Atlanta, GA
    • NPI 1336196468

    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 Georgia, Inc.

    CMS ownership
  • Pruitthealth - Christian City, LLC

    dba Christian City Rehabilitation Center

    • Skilled Nursing Facility
    • Union City, GA
    • NPI 1720221328

    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 Georgia, Inc.

    CMS ownership
  • Pruitthealth - Covington LLC

    dba PruittHealth - Covington

    • Skilled Nursing Facility
    • Covington, GA
    • NPI 1457797177

    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 Georgia, Inc.

    CMS ownership
  • Pruitthealth - Creekside, LLC
    • Skilled Nursing Facility
    • Augusta, GA
    • NPI 1104536077

    United Health Services of Georgia, Inc.

    CMS ownership
  • Pruitthealth - Crestwood, LLC
    • Skilled Nursing Facility
    • Valdosta, GA
    • NPI 1063036200

    J Paige Pruitt Trust, Lisa P Hamby Trust, Neil L Pruitt Jr Trust, United Health Services Inc, United Health Services of Georgia, Inc.

    CMS ownership
View all 123

Practitioners & affiliated clinicians

Practitioners 45

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.

View all 45

Affiliated clinicians 17

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 17

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1149292800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1617753600000",
    "number": "1013955749",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "667 SOUTH MAIN STREET",
            "city": "SWAINSBORO",
            "state": "GA",
            "postal_code": "304014818",
            "telephone_number": "478-237-7798",
            "fax_number": "478-237-6670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRUITTHEALTH HOSPICE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-03",
        "last_updated": "2021-04-07",
        "certification_date": "2021-03-17",
        "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",
        "authorized_official_telephone_number": "770-279-6200",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00849505A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PruittHealth Hospice - Swainsboro",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "PruittHealth Hospice - Swainsboro",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Swainsboro, GA

Sources for this page

Verify at the official NPI Registry.