Pruitthealth - Creekside, LLC
Organization Active NPI Skilled Nursing Facility · Augusta, GA
NPI 1104536077 · NPPES record last updated Dec 1, 2022
Key facts
- NPI
- 1104536077
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Skilled Nursing Facility 314000000X
- Legal business name
- PRUITTHEALTH - CREEKSIDE, LLC
- Practice address
- 2021 Scott Rd
Augusta, GA 30906-2539 - Phone
- (770) 279-6200
- NPI assigned
- Dec 1, 2022
- Organization subpart
- No
Authorized official
- Name
- Neil L Pruitt Jr.
- Title
- Chairman and Ceo
- Phone
- (770) 279-6200
Owners & managing parties with NPI records 1
-
Luther M Thomas III, M.D.
Facilities with the same owner 88
Practitioners 2
-
Luther M Thomas III, M.D.
Affiliated clinicians 2
-
Luther M Thomas III, M.D.
Medicare Care Compare: Nursing home
- Listed as
- Pruitthealth - Creekside
- Overall star rating
- ★★☆☆☆ 2 of 5
- Health inspections
- ★★★☆☆ 3 of 5
- Staffing
- ★☆☆☆☆ 1 of 5
- Quality measures
- ★★★★☆ 4 of 5
- Type
- Medicare and Medicaid
- Ownership
- For profit - Corporation
- Certified
- Apr 12, 2024
- Medicare certification status
- Active
- Certified beds
- 193 · 82.4 residents per day on average
- Chain
- Pruitthealth
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 11D2271213 | Pruitthealth-Creekside, LLC | Certificate of waiver | Oct 30, 2026 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
Skilled nursing facility certification: CCN 115777
- Legal name
- PRUITTHEALTH - CREEKSIDE LLC
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Apr 12, 2024
- Last certification
- May 4, 2025
- Beds
- 193
- Ownership / control type
- Corporation
- Multi-facility organization
- Pruitthealth
- Organization structure
- LLC · Proprietary
- Incorporated
- May 1, 2022 in GA
- Enrollment address
- 2021 Scott Rd
Augusta, GA 30906-2539 - Nursing home name
- PRUITTHEALTH - CREEKSIDE
- Affiliated entity
- PRUITTHEALTH
All disclosed owners & managing parties 19
| Name | Role | Since | Share |
|---|---|---|---|
| |
Indirect Ownership Interest | Aug 12, 2020 | 2.4% |
| |
Adp of the SNF | Jan 14, 2025 | |
| Indirect Ownership Interest | Jan 14, 2025 | 1.59% | |
| United Health Services Inc |
Indirect Ownership Interest | Sep 1, 2022 | 100% |
| Philip W. Small |
Corporate Director |
Jan 3, 2011 | |
| |
Adp of the SNF | Nov 11, 2019 | |
| Lisa P Hamby Trust |
Adp of the SNF | Jun 22, 2021 | |
| Indirect Ownership Interest | Jun 22, 2021 | 22.98% | |
| Neil Little Pruitt |
Corporate Officer |
Nov 27, 2013 | 1% |
| Direct Ownership Interest | Nov 27, 2013 | 1% | |
| Neil L Pruitt Jr Trust |
Adp of the SNF | Jun 22, 2021 | |
| Indirect Ownership Interest | Jun 22, 2021 | 42.86% | |
| NWP 2020 Child TR Fbo Neil L Pruitt Jr |
Adp of the SNF | Aug 12, 2020 | |
| Indirect Ownership Interest | Aug 12, 2020 | 6.29% | |
| Luther M Thomas |
Operational/Managerial Control | Nov 12, 2023 | |
| Adp of the SNF | Nov 17, 2025 | ||
| |
Adp of the SNF | Aug 5, 2011 | |
| Nancy W Pruitt |
Managing Control - Governing Body |
Nov 27, 2013 | |
| Jessica Love |
Operational/Managerial Control | Oct 10, 2022 | |
| Adp of the SNF | Sep 12, 2025 | ||
| Pruitthealth Consulting Services Inc |
Adp of the SNF | Nov 26, 2013 | |
| |
Adp of the SNF | Jun 1, 2008 | |
| Uhs-Pruitt Holdings, Inc. |
Indirect Ownership Interest | Sep 1, 2022 | |
| |
Adp of the SNF | Aug 12, 2020 | |
| Indirect Ownership Interest | Aug 12, 2020 | 2.4% | |
| United Health Services of Georgia, Inc. |
5% Or Greater Direct Ownership Interest | Nov 27, 2013 | 99% |
| Direct Ownership Interest | Sep 1, 2022 | 99% | |
| J Paige Pruitt Trust |
Adp of the SNF | Jun 22, 2021 | |
| Indirect Ownership Interest | Jun 22, 2021 | 21.44% |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20231209000682 | GA | Part a Provider - Skilled Nursing Facility | 6305293770 | Practice locations: Augusta, GA |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | Yes |
Addresses
Primary practice location
2021 Scott Rd
Augusta, GA 30906-2539
Mailing address
1626 Jeurgens CT
Attn: Legal Dept
Norcross, GA 30093
Phone (770) 279-6200
Other providers in Augusta, GA
- Amanda Kent Pruitt
- Jerry N. Pruitt
- Michael Frederic Pruitt
- Pruitthealth - Augusta Hills LLC
- Pruitthealth - Augusta, LLC
- Pruitthealth - Richmond, LLC
- Pruitthealth Dialysis Services, Inc.
- Pruitthealth Home First, Inc.
- Pruitthealth Home Health, Inc.
- Pruitthealth Hospice, Inc.
All providers in Augusta, GA · Skilled Nursing Facility in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 1, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.