Active NPI
C.R. of Autumn Breeze, LLC
Doing business as Autumn Breeze Health and Rehab
- Skilled Nursing Facility
- Marietta, GA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- Legal business name
- C.R. OF AUTUMN BREEZE, LLC
- Doing business as
- Autumn Breeze Health and Rehab
- Practice address
- 1480 Sandtown Rd SW
Marietta, GA 30008-3821 - Phone
- (770) 442-1755
- Fax
- (770) 442-8784
- NPI assigned
- Aug 10, 2015
- Last updated
- Aug 10, 2015
- 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
- Michael E Winget Sr.
- Title
- Member
- Phone
- (478) 994-3669
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | NU | Primary |
Addresses
Primary practice location
1480 Sandtown Rd SW
Marietta, GA 30008-3821
Mailing address
1480 Sandtown Rd SW
Marietta, GA 30008-3821
Phone (770) 442-1755
Other names 1
- Autumn Breeze Health and Rehab
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20151125000956 | GA | Part A Provider - Skilled Nursing Facility | 2365742251 | Practice locations: Marietta, GA |
NPI to CCN mapping 1
The Medicare certification numbers (CCNs) connected to NPI 1053797340. Details of each certification follow.
Skilled nursing facility certification: CCN 115580
- Legal name
- C.R. OF AUTUMN BREEZE, LLC
- Doing business as
- AUTUMN BREEZE HEALTH AND REHAB
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Mar 1, 1995
- Last certification
- Feb 6, 2025
- Beds
- 109
- Ownership / control type
- Corporation
- Multi-facility organization
- Regional Health Properties
- Organization structure
- LLC
- Incorporated
- Jan 29, 2015 in GA
- Enrollment address
- 1480 Sandtown Rd SW
Marietta, GA 30008-3821
Care Compare: Nursing home
Medicare Care Compare- Listed as
- Sandtown Health and Rehabilitation
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- For profit - Corporation
- Certified
- Mar 1, 1995
- Medicare certification status
- Active
- Certified beds
- 109
National Provider Directory
National Provider DirectoryOwnership & related parties
All disclosed owners & managing parties 9
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 |
|---|---|---|---|
| C. Ross Management LLC | Adp of the SNF | Mar 7, 2025 | |
| Adp of the SNF | Oct 1, 2015 | ||
| Adp of the SNF | Oct 1, 2015 | ||
| Carrol L Janes | Operational/Managerial Control | Sep 1, 2023 | |
| Adp of the SNF | Sep 1, 2023 | ||
| Michael Eugene Winget | 5% Or Greater Direct Ownership Interest | Oct 1, 2015 | 99% |
| Corporate Officer | Oct 1, 2015 | ||
| Operational/Managerial Control | Oct 1, 2015 | 99% | |
| Adp of the SNF | Oct 1, 2015 | ||
| Direct Ownership Interest | Oct 1, 2015 | 1% | |
| Adp of the SNF | Feb 21, 2025 | ||
| Adp of the SNF | Oct 1, 2015 | ||
| Adp of the SNF | Feb 21, 2025 |
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.
-
- Internal Medicine Physician
- Dallas, GA
- NPI 1407056302
-
- Family Medicine Physician
- Tucker, GA
- NPI 1285761833
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1439164800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1439164800000",
"number": "1053797340",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1480 SANDTOWN RD SW",
"city": "MARIETTA",
"state": "GA",
"postal_code": "300083821",
"telephone_number": "770-442-1755",
"fax_number": "770-442-8784"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1480 SANDTOWN RD SW",
"city": "MARIETTA",
"state": "GA",
"postal_code": "300083821",
"telephone_number": "770-442-1755",
"fax_number": "770-442-8784"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "C.R. OF AUTUMN BREEZE, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2015-08-10",
"last_updated": "2015-08-10",
"status": "A",
"authorized_official_last_name": "WINGET",
"authorized_official_first_name": "MICHAEL",
"authorized_official_middle_name": "E",
"authorized_official_title_or_position": "MEMBER",
"authorized_official_telephone_number": "478-994-3669",
"authorized_official_name_suffix": "Sr."
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Autumn Breeze Health and Rehab",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Marietta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2015; 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.