NPIMap

Organization Active NPI

Goodwater Healthcare Center LLC

  • Skilled Nursing Facility
  • Goodwater, AL
National Provider Identifier
1063465052
Registry record updated Aug 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
12510 Issued in AL
Legal business name
GOODWATER HEALTHCARE CENTER LLC
Practice address
16 Jones Hill Rd
Goodwater, AL 35072-9463
Phone
(256) 839-6711
Fax
(256) 839-6707
NPI assigned
May 18, 2006
Last updated
Aug 20, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Ladonna Chambers
Title
Billing Office Manager
Phone
(256) 839-6711

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 12510 AL Primary

Addresses

Primary practice location

16 Jones Hill Rd
Goodwater, AL 35072-9463

Mailing address

16 Jones Hill Rd
Goodwater, AL 35072-9463
Phone (256) 839-6711

Other identifiers 1

IdentifierTypeStateIssuer
4755800SMedicaidAL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040210000834 AL Part A Provider - Skilled Nursing Facility 5597659698 Practice locations: Goodwater, AL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1063465052. Details of each certification follow.

Skilled nursing facility certification: CCN 015204

Legal name
GOODWATER HEALTHCARE CENTER LLC
Doing business as
GOODWATER HEALTHCARE CENTER
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Jul 1, 1978
Last certification
Apr 15, 2021
Beds
72
Ownership / control type
Corporation
Multi-facility organization
PRIME HEALTHCARE
Most recent change of ownership
Jan 1, 2004
Organization structure
LLCProprietary
Incorporated
Jan 1, 2004 in AL
Enrollment address
16 Jones Hill Rd
Goodwater, AL 35072-9463
Nursing home name
GOODWATER HEALTHCARE CENTER
Affiliated entity
PRIME HEALTH CARE ENTERPRISES

Care Compare: Nursing home

Medicare Care Compare
Listed as
Goodwater Healthcare CenterCCN 015204 · All quality measures
Overall star rating
5 of 5
Health inspections
5 of 5
Staffing
5 of 5
Quality measures
3 of 5
Type
Medicare and Medicaid
Ownership
For profit - Corporation
Certified
Jul 1, 1978
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
7261.5 residents per day on average
Chain
Prime Health Care Enterprises5 facilities in the chain

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 4

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

NameRoleSinceShare
Archie J. Chapman Individual 5% Or Greater Direct Ownership Interest Jul 29, 2016
Corporate Director Jul 29, 2016
W-2 Managing Employee Jul 29, 2016
Prime Healthcare Enterprise LLC Organization, Dadeville, AL Created for acquisition, For-profit 5% Or Greater Direct Ownership Interest May 28, 2004
Prime Management, LLC Organization, Dadeville, AL For-profit Operational/Managerial Control Nov 18, 2003
Servisfirst Bank Organization, Montgomery, AL Financial institution 5% Or Greater Mortgage Interest Mar 28, 2012 63%

Facilities with the same owner 3

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

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 1

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": "1147910400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1755648000000",
    "number": "1063465052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 JONES HILL RD",
            "city": "GOODWATER",
            "state": "AL",
            "postal_code": "350729463",
            "telephone_number": "256-839-6711",
            "fax_number": "256-839-6707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16 JONES HILL RD",
            "city": "GOODWATER",
            "state": "AL",
            "postal_code": "350729463",
            "telephone_number": "256-839-6711",
            "fax_number": "256-839-6707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOODWATER HEALTHCARE CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-18",
        "last_updated": "2025-08-20",
        "certification_date": "2025-08-20",
        "status": "A",
        "authorized_official_last_name": "CHAMBERS",
        "authorized_official_first_name": "LADONNA",
        "authorized_official_title_or_position": "BILLING OFFICE MANAGER",
        "authorized_official_telephone_number": "256-839-6711"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "AL",
            "license": "12510",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4755800S",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Goodwater, AL

Sources for this page

Verify at the official NPI Registry.