NPIMap

Organization Active NPI

Lifebrite Hospital Group of Early LLC

  • Medicare Defined Swing Bed Hospital Unit
  • Blakely, GA
National Provider Identifier
1104358811
Registry record updated Aug 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medicare Defined Swing Bed Hospital UnitTaxonomy code 275N00000X
License
049-697 Issued in GA
Legal business name
LIFEBRITE HOSPITAL GROUP OF EARLY LLC
Practice address
11740 Columbia St
Blakely, GA 39823-2574
Phone
(229) 723-4841
NPI assigned
Mar 31, 2017
Last updated
Aug 23, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
LIFEBRITE HOSPITAL GROUP OF EARLY LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 23, 2023

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

Authorized official

Name
Morgan Dunn
Title
Ceo
Phone
(601) 849-6440

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medicare Defined Swing Bed Hospital Unit 275N00000X 049-697 GA Primary

Addresses

Primary practice location

11740 Columbia St
Blakely, GA 39823-2574

Mailing address

11740 Columbia St
Blakely, GA 39823-2574

Other names 1

  • Swing Bed Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20171130002442 GA Part A Provider - Critical Access Hospital 7810263589 Receives reassigned benefits from 4 practitioners
Practice locations: Blakely, GA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1104358811. Details of each certification follow.

Hospital certification: CCN 11Z314

Legal name
LIFEBRITE HOSPITAL GROUP OF EARLY LLC
Doing business as
LIFEBRITE COMMUNITY HOSPITAL OF EARLY
Organization structure
LLCProprietary
Incorporated
Mar 17, 2017 in GA
Enrollment address
11740 Columbia St
Blakely, GA 39823-2574
Other Hospital Practice Location

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 5

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

National Provider Directory

National Provider Directory
Tax ID family
Lifebrite Hospital Group6 organizations share this tax ID, including this one
Part of
Lifebrite Hospital Group

Other organizations with this tax ID 5

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

Ownership & related parties

All disclosed owners & managing parties 3

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

NameRoleSinceShare
Echp, Inc. Organization, Magee, MS Corporation, For-profit 5% Or Greater Direct Ownership Interest Feb 1, 2023 100%
Morgan Dunn Individual 5% Or Greater Direct Ownership InterestManager Feb 1, 2023 100%
Ginger Cushing Individual W-2 Managing EmployeeCeo Nov 1, 2017

Facilities with the same owner 3

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

Practitioners & affiliated clinicians

Practitioners 4

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": "1490918400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1692748800000",
    "number": "1104358811",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11740 COLUMBIA ST",
            "city": "BLAKELY",
            "state": "GA",
            "postal_code": "398232574"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11740 COLUMBIA ST",
            "city": "BLAKELY",
            "state": "GA",
            "postal_code": "398232574",
            "telephone_number": "229-723-4841"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFEBRITE HOSPITAL GROUP OF EARLY LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LIFEBRITE HOSPITAL GROUP OF EARLY LLC",
        "enumeration_date": "2017-03-31",
        "last_updated": "2023-08-23",
        "certification_date": "2023-08-23",
        "status": "A",
        "authorized_official_last_name": "DUNN",
        "authorized_official_first_name": "MORGAN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "601-849-6440"
    },
    "taxonomies": [
        {
            "code": "275N00000X",
            "taxonomy_group": "",
            "desc": "Medicare Defined Swing Bed Unit",
            "state": "GA",
            "license": "049-697",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Swing Bed",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Swing Bed",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Blakely, GA

Sources for this page

Verify at the official NPI Registry.