NPIMap

GHHS Healthcare, LLC

Organization Active NPI Home Health Agency · Valdosta, GA

NPI 1114174992 · NPPES record last updated Jun 6, 2018

Key facts

NPI
1114174992
Entity type
Organization (NPI type 2)
Primary specialty
Home Health Agency 251E00000X
Legal business name
GHHS HEALTHCARE, LLC
Practice address
4380 Kings Way
Valdosta, GA 31602
Phone
(229) 247-4663
NPI assigned
Aug 22, 2008
Organization subpart
No

Authorized official

Name
Mr. James T Poteet Jr.
Title
President
Phone
(423) 667-4611

Affiliated clinicians 54

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 54

Medicare Care Compare: Home health agency

Listed as
Georgia Home Health Services CCN 117058
Overall star rating
★★★☆☆ 3 of 5
Ownership
Proprietary
Certified
Jun 25, 1979
Medicare certification status
Active (Provider of Services file)
Services
Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

Source: Medicare Care Compare.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in GA

Home health agency certification: CCN 117058

Legal name
GHHS HEALTHCARE, LLC
Doing business as
GEORGIA HOME HEALTH SERVICES
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Jun 25, 1979
Last certification
Nov 8, 2018
Ownership / control type
Proprietary
Organization structure
LLC · Proprietary
Enrollment address
4380 Kings Way
Valdosta, GA 31602-6921

All disclosed owners & managing parties 11

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

NameRoleSinceShare
James Thomas Poteet
Individual 		5% Or Greater Indirect Ownership Interest Jun 23, 2011 25%
Corporate Officer
President		 Jun 23, 2011
W-2 Managing Employee Jun 23, 2011
LJP Medical Investor Group LLC
Organization · Valdosta, GA
Created for acquisition, LLC 		5% Or Greater Direct Ownership Interest Jun 23, 2011 100%
Operational/Managerial Control Jun 23, 2011
Carden B Rice
Individual 		5% Or Greater Indirect Ownership Interest Jun 23, 2011 7.5%
Caren Bennefield
Individual 		W-2 Managing Employee Mar 8, 2018
Operational/Managerial Control
Administrator		 Mar 8, 2018
Kari Tucker Snow
Individual 		W-2 Managing Employee
Ad;		 May 5, 2026
Charles E. Jabaley Family Trust
Organization · Cleveland, TN 		5% Or Greater Indirect Ownership Interest Nov 10, 2020 30%
Berrien Holdings, LLC
Organization · Jacksonville, FL
LLC 		5% Or Greater Indirect Ownership Interest Jun 24, 2011 75%
William Burton
Individual 		5% Or Greater Indirect Ownership Interest Jun 23, 2011 7.5%
Fred Lester
Individual 		5% Or Greater Indirect Ownership Interest Jun 23, 2011 30%
Corporate Officer Jun 23, 2011
CBR Berrien Investments LLC
Organization · Cumming, GA
LLC 		5% Or Greater Indirect Ownership Interest Jun 24, 2011 7.5%
L&J Associates LLC
Organization · Jacksonville, FL
LLC 		5% Or Greater Indirect Ownership Interest Jun 24, 2011 60%

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20120427000629 GA Part a Provider - Home Health Agency 3173785649 Practice locations: Tifton, GA; Valdosta, GA

National Provider Directory

Locations

111 S Davis St
Nashville, GA 31639
Phone (229) 686-5502

4380 Kings Way
Valdosta, GA 31602
Phone (229) 244-2068

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Yes

Addresses

Primary practice location

4380 Kings Way
Valdosta, GA 31602

Mailing address

3404 Greystone Way
Valdosta, GA 31605-1048
Phone (229) 247-4663

Other names

  • Georgia Home Health Services Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jun 6, 2018.

{
    "created_epoch": "1219363200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1528243200000",
    "number": "1114174992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3404 GREYSTONE WAY",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316051048",
            "telephone_number": "229-247-4663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4380 KINGS WAY",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "31602",
            "telephone_number": "229-247-4663"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GHHS HEALTHCARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-22",
        "last_updated": "2018-06-06",
        "status": "A",
        "authorized_official_last_name": "POTEET",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "423-667-4611",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Georgia Home Health Services",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Georgia Home Health Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Valdosta, GA

All providers in Valdosta, GA · Home Health Agency in Georgia

Sources for this page

Verify at the official NPI Registry.