Organization Active NPI

Pruitthealth - Palmyra, LLC

Doing business as PruittHealth - Palmyra

  • Skilled Nursing Facility
  • Albany, GA
National Provider Identifier
1073926408
Registry record updated Dec 22, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
PRUITTHEALTH - PALMYRA, LLC
Doing business as
PruittHealth - Palmyra
Practice address
1904 Palmyra Rd
Albany, GA 31701-1575
Phone
(229) 883-0500
Fax
(229) 438-7203
NPI assigned
Jun 3, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2014

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

Authorized official

Name
Mr. Neil L. Pruitt Jr.
Title
Chairman and Ceo of Manager
Phone
(770) 279-6200

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

1904 Palmyra Rd
Albany, GA 31701-1575

Mailing address

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

Other names 1

  • PruittHealth - Palmyra Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140814002780 GA Part A Provider - Skilled Nursing Facility 0143447128 Practice locations: Albany, GA

Skilled nursing facility certification: CCN 115628

Legal name
PRUITTHEALTH - PALMYRA, LLC
Doing business as
PRUITTHEALTH - PALMYRA
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Jan 1, 1997
Last certification
Feb 29, 2024
Beds
250
Ownership / control type
Limited Liability Corporation
Multi-facility organization
PRUITTHEALTH
Organization structure
LLCProprietary
Incorporated
May 21, 2012 in GA
Enrollment address
1904 Palmyra Rd
Albany, GA 31701-1575
Nursing home name
PRUITTHEALTH - PALMYRA
Affiliated entity
PRUITTHEALTH

Care Compare: Nursing home

Medicare Care Compare
Listed as
Pruitthealth - PalmyraCCN 115628 · All quality measures
Overall star rating
1 of 5
Health inspections
1 of 5
Staffing
2 of 5
Quality measures
2 of 5
Type
Medicare and Medicaid
Ownership
For profit - Limited Liability company
Certified
Jan 1, 1997
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
250195.8 residents per day on average
Chain
Pruitthealth95 facilities in the chain
Penalties (3 years)
2Fines totaling $48,909

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
11D0265814Pruitthealth - Palmyra, LLC1904 Palmyra Rd, Albany, GA 31701Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 10

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

NameRoleSinceShare
Kenneth E Burnett Individual W-2 Managing EmployeeFacility Administrator Jan 31, 2020 100%
United Health Services Inc Organization, Norcross, GA Corporation, For-profit 5% Or Greater Indirect Ownership Interest May 21, 2012 100%
Pruitthealth Inc Organization, Norcross, GA Corporation, For-profit Other May 21, 2012
Lisa P Hamby Trust Organization, Norcross, GA 5% Or Greater Indirect Ownership Interest May 21, 2012 28.84%
Neil Little Pruitt Individual Corporate OfficerChairman and Ceo May 21, 2012 100%
Corporate DirectorChairman and Ceo May 21, 2012 100%
Operational/Managerial ControlChain Home Office Administrator May 21, 2012 100%
OtherCho Administrator May 21, 2012 100%
Neil L Pruitt Jr Trust Organization, Norcross, GA 5% Or Greater Indirect Ownership Interest May 21, 2012 35.2%
Richard E Fallaw Individual W-2 Managing EmployeeFacility Administrator Sep 26, 2020 100%
Uhs-Pruitt Holdings, Inc. Organization, Norcross, GA Corporation, For-profit 5% Or Greater Indirect Ownership Interest May 21, 2012 100%
United Health Services of Georgia, Inc. Organization, Norcross, GA Corporation, For-profit 5% Or Greater Direct Ownership Interest May 21, 2012 99%
J Paige Pruitt Trust Organization, Norcross, GA 5% Or Greater Indirect Ownership Interest May 21, 2012 26.13%

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 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

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": "1401753600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1419206400000",
    "number": "1073926408",
    "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": "770-931-5278"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1904 PALMYRA RD",
            "city": "ALBANY",
            "state": "GA",
            "postal_code": "317011575",
            "telephone_number": "229-883-0500",
            "fax_number": "229-438-7203"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRUITTHEALTH - PALMYRA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-03",
        "last_updated": "2014-12-22",
        "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_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PruittHealth - Palmyra",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Albany, GA

Sources for this page

Verify at the official NPI Registry.