Active NPI
Pruitthealth Hospice, Inc.
- Inpatient Hospice
- Duluth, GA
National Provider Identifier
1043258148
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Inpatient Hospice
- Legal business name
- PRUITTHEALTH HOSPICE, INC.
- Practice address
- 3430 Duluth Park LN
Duluth, GA 30096-3257 - Phone
- (770) 232-7727
- NPI assigned
- Jun 2, 2006
- 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 & Ceo of MGR
- Phone
- (770) 279-6200
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Inpatient Hospice | 315D00000X | Primary |
Addresses
Primary practice location
3430 Duluth Park LN
Duluth, GA 30096-3257
Mailing address
1626 Jeurgens CT
Norcross, GA 30093-2219
Phone (770) 279-6200
Other names 1
- Peachtree Christian Inpatient
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20060308000165 | GA | Part A Provider - Hospice | 2264344217 |
1 other NPI on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Norcross, GA |
Hospice certification: CCN 111533
- Legal name
- PRUITTHEALTH HOSPICE INC
- Doing business as
- PRUITTHEALTH HOSPICE - ATLANTA
- Certification status
- Active
- Provider type (POS)
- Hospice
- Participating since
- Dec 14, 1993
- Last certification
- Feb 9, 2022
- Ownership / control type
- Proprietary - Corporation
- Organization structure
- Corporation
- Incorporated
- Oct 14, 1993 in GA
- Enrollment address
- 5365 Oakbrook Pkwy
Norcross, GA 30093-2250
Other NPIs on the same Medicare enrollment 1
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
-
- Community Based Hospice Care Agency
- Norcross, GA
- NPI 1316985336
O20060308000165
Care Compare: Hospice
Medicare Care Compare- Listed as
- Pruitthealth Hospice and Palliative Care-Atlanta
- Ownership
- For-Profit
- Certified
- Dec 14, 1993
- Medicare certification status
- Active
National Provider Directory
National Provider DirectoryOwnership & 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.
| Name | Role | Since | Share |
|---|---|---|---|
| United Health Services Inc | 5% Or Greater Indirect Ownership Interest | Jan 2, 2006 | 100% |
| Philip W. Small | Corporate Director | Sep 17, 2013 | |
| Pruitthealth Inc | 5% Or Greater Direct Ownership Interest | Jan 1, 2022 | |
| Operational/Managerial Control | Jan 7, 2008 | ||
| Lisa P Hamby Trust | 5% Or Greater Indirect Ownership Interest | Jan 2, 2006 | 31.65% |
| Neil Little Pruitt | Corporate Officer | Feb 23, 2007 | |
| Corporate Director | Feb 23, 2007 | ||
| Other | Jan 2, 2006 | ||
| Neil L Pruitt Jr Trust | 5% Or Greater Indirect Ownership Interest | Jan 2, 2006 | 35.93% |
| Nancy W Pruitt | Corporate Officer | Jan 2, 2006 | |
| Uhs-Pruitt Holdings, Inc. | 5% Or Greater Indirect Ownership Interest | Jan 2, 2006 | 100% |
| Thomas R Beddingfield | Corporate Director | Sep 17, 2013 | |
| United Health Services of Georgia, Inc. | 5% Or Greater Direct Ownership Interest | Jan 7, 2008 | 99% |
| J Paige Pruitt Trust | 5% Or Greater Indirect Ownership Interest | Jan 2, 2006 | 31.32% |
| Monica Hollison Peebles | W-2 Managing Employee | Nov 13, 2022 |
Practitioners & affiliated clinicians
Affiliated clinicians 8
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": "1149206400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1406160000000",
"number": "1043258148",
"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",
"fax_number": "706-827-2048"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3430 DULUTH PARK LN",
"city": "DULUTH",
"state": "GA",
"postal_code": "300963257",
"telephone_number": "770-232-7727"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PRUITTHEALTH HOSPICE, INC.",
"organizational_subpart": "NO",
"enumeration_date": "2006-06-02",
"last_updated": "2014-07-24",
"status": "A",
"authorized_official_last_name": "PRUITT",
"authorized_official_first_name": "NEIL",
"authorized_official_middle_name": "L.",
"authorized_official_title_or_position": "CHAIRMAN & CEO OF MGR",
"authorized_official_telephone_number": "770-279-6200",
"authorized_official_name_suffix": "Jr."
},
"taxonomies": [
{
"code": "315D00000X",
"taxonomy_group": "",
"desc": "Hospice, Inpatient",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Peachtree Christian Inpatient",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Duluth, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2014; 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.