Active NPI
Pruitthealth - Conway, LLC
Doing business as PruittHealth - Conway at Conway Medical Center
- Skilled Nursing Facility
- Conway, SC
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- Legal business name
- PRUITTHEALTH - CONWAY, LLC
- Doing business as
- PruittHealth - Conway at Conway Medical Center
- Practice address
- 2379 Cypress Cir
Conway, SC 29526-8921 - Phone
- (843) 347-8179
- NPI assigned
- Oct 31, 2018
- Last updated
- May 29, 2019
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Neil L. Pruitt Jr.
- Title
- Chairman and Ceo of Manager
- Phone
- (770) 279-6200
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | Primary |
Addresses
Primary practice location
2379 Cypress Cir
Conway, SC 29526-8921
Mailing address
1626 Jeurgens CT
Norcross, GA 30093-2219
Phone (770) 279-6200
Other names 1
- PruittHealth - Conway at Conway Medical Center
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in SC
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20181207000980 | SC | Part A Provider - Skilled Nursing Facility | 4880938414 | Practice locations: Conway, SC |
NPI to CCN mapping 1
The Medicare certification numbers (CCNs) connected to NPI 1124595863. Details of each certification follow.
Skilled nursing facility certification: CCN 425173
- Legal name
- PRUITTHEALTH - CONWAY, LLC
- Doing business as
- PRUITTHEALTH - CONWAY AT CONWAY MEDICAL CENTER
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Jun 16, 1989
- Last certification
- May 13, 2025
- Beds
- 88
- Ownership / control type
- Corporation
- Multi-facility organization
- PruittHealth
- Organization structure
- LLC
- Incorporated
- Sep 4, 2018 in SC
- Enrollment address
- 2379 Cypress Cir
Conway, SC 29526-8921 - Nursing home name
- PRUITTHEALTH- CONWAY AT CONWAY MEDICAL CENTER
- Affiliated entity
- PRUITTHEALTH
Care Compare: Nursing home
Medicare Care Compare- Listed as
- PruittHealth- Conway At Conway Medical Center
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- For profit - Corporation
- Certified
- Jun 16, 1989
- Medicare certification status
- Active
- Certified beds
- 88
- Chain
- Pruitthealth
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 42D1006866 | Pruitthealth - Conway, LLC | Certificate of waiver | Dec 2, 2026 |
National Provider Directory
National Provider DirectoryOwnership & related parties
All disclosed owners & managing parties 20
As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.
| Name | Role | Since | Share |
|---|---|---|---|
| Uhs- Pruitt Holdings Inc | 5% Or Greater Indirect Ownership Interest | Sep 4, 2018 | 100% |
| Indirect Ownership Interest | Sep 4, 2019 | 99% | |
| Adp of the SNF | Aug 12, 2020 | ||
| Indirect Ownership Interest | Aug 12, 2020 | 6.29% | |
| Indirect Ownership Interest | Aug 12, 2020 | 2.4% | |
| United Health Services Inc | 5% Or Greater Indirect Ownership Interest | Sep 4, 2018 | 99% |
| Indirect Ownership Interest | Sep 4, 2018 | 99% | |
| Adp of the SNF | Aug 18, 2020 | ||
| Indirect Ownership Interest | Aug 18, 2020 | 1.59% | |
| Adp of the SNF | Nov 27, 2013 | ||
| Philip W. Small | Corporate Director | Nov 27, 2013 | |
| Adp of the SNF | Nov 11, 2019 | ||
| Lisa P Hamby Trust | 5% Or Greater Indirect Ownership Interest | Jun 22, 2021 | 21.44% |
| Adp of the SNF | Jun 22, 2021 | ||
| Indirect Ownership Interest | Jun 22, 2021 | 21.44% | |
| Neil Little Pruitt | Corporate Officer | Nov 27, 2013 | 1% |
| Direct Ownership Interest | Nov 27, 2013 | 1% | |
| Adp of the SNF | Nov 27, 2013 | ||
| United Health Services of South Carolina Inc | 5% Or Greater Direct Ownership Interest | Sep 4, 2018 | 99% |
| Direct Ownership Interest | Sep 4, 2018 | 99% | |
| Neil L Pruitt Jr Trust | 5% Or Greater Indirect Ownership Interest | Jun 22, 2021 | 42.86% |
| Adp of the SNF | Jun 22, 2021 | ||
| Indirect Ownership Interest | Jun 22, 2021 | 42.86% | |
| NWP 2020 Child TR Fbo Neil L Pruitt Jr | Indirect Ownership Interest | Aug 12, 2020 | 6.29% |
| Adp of the SNF | Oct 8, 2018 | ||
| Indirect Ownership Interest | Apr 12, 2024 | ||
| Cindy Robbins | Operational/Managerial Control | Sep 23, 2024 | |
| Adp of the SNF | Mar 28, 2025 | ||
| Nancy W Pruitt | Corporate Officer | Nov 27, 2013 | |
| Adp of the SNF | Mar 28, 2025 | ||
| Pruitthealth Consulting Services Inc | Adp of the SNF | Nov 26, 2013 | |
| J Paige Pruitt Trust | 5% Or Greater Indirect Ownership Interest | Jun 22, 2021 | 21.44% |
| Adp of the SNF | Jun 22, 2021 | ||
| Indirect Ownership Interest | Jun 22, 2021 | 21.44% |
Facilities with the same owner 121
Facilities that share an organizational owner with 5% or greater ownership or operational control.
-
dba PruittHealth - Aiken
- Skilled Nursing Facility
- Aiken, SC
- NPI 1679786917
J Paige Pruitt Trust, United Health Services Inc, United Health Services of South Carolina Inc
-
dba PruittHealth - Bamberg
- Skilled Nursing Facility
- Bamberg, SC
- NPI 1104063718
J Paige Pruitt Trust, Lisa P Hamby Trust, Neil L Pruitt Jr Trust, United Health Services Inc, United Health Services of South Carolina Inc
-
dba PruittHealth - Barnwell
- Skilled Nursing Facility
- Barnwell, SC
- NPI 1962729632
J Paige Pruitt Trust, Lisa P Hamby Trust, Neil L Pruitt Jr Trust, United Health Services Inc, United Health Services of South Carolina Inc
-
dba PruittHealth - Columbia
- Skilled Nursing Facility
- Columbia, SC
- NPI 1790732212
J Paige Pruitt Trust, Lisa P Hamby Trust, Neil L Pruitt Jr Trust, United Health Services Inc, United Health Services of South Carolina Inc
-
dba PruittHealth - Dillon
- Skilled Nursing Facility
- Dillon, SC
- NPI 1639125198
J Paige Pruitt Trust, Lisa P Hamby Trust, Neil L Pruitt Jr Trust, United Health Services Inc, United Health Services of South Carolina Inc
-
dba PruittHealth - Moncks Corner
- Skilled Nursing Facility
- Moncks Corner, SC
- NPI 1700074564
J Paige Pruitt Trust, Lisa P Hamby Trust, Neil L Pruitt Jr Trust, United Health Services Inc, United Health Services of South Carolina Inc
-
dba PruittHealth - North Augusta
- Skilled Nursing Facility
- North Augusta, SC
- NPI 1790951192
J Paige Pruitt Trust, Lisa P Hamby Trust, Neil L Pruitt Jr Trust, United Health Services Inc, United Health Services of South Carolina Inc
-
dba PruittHealth - Orangeburg
- Skilled Nursing Facility
- Orangeburg, SC
- NPI 1013917053
J Paige Pruitt Trust, Lisa P Hamby Trust, Neil L Pruitt Jr Trust, United Health Services Inc, United Health Services of South Carolina Inc
-
dba PruittHealth - Pickens
- Skilled Nursing Facility
- Six Mile, SC
- NPI 1073789475
J Paige Pruitt Trust, Lisa P Hamby Trust, Neil L Pruitt Jr Trust, United Health Services Inc, United Health Services of South Carolina Inc
-
dba PruittHealth - Rock Hill
- Skilled Nursing Facility
- Rock Hill, SC
- NPI 1992752414
J Paige Pruitt Trust, Lisa P Hamby Trust, Neil L Pruitt Jr Trust, United Health Services Inc, United Health Services of South Carolina Inc
-
dba PruittHealth - Walterboro
- Skilled Nursing Facility
- Walterboro, SC
- NPI 1386691806
J Paige Pruitt Trust, Lisa P Hamby Trust, Neil L Pruitt Jr Trust, United Health Services Inc, United Health Services of South Carolina Inc
-
dba PruittHealth Home Health - Columbia
- Home Health Agency
- Columbia, SC
- NPI 1033533344
J Paige Pruitt Trust, Lisa P Hamby Trust, Neil L Pruitt Jr Trust, United Health Services Inc
Practitioners & affiliated clinicians
Affiliated clinicians 2
Clinicians who list this facility as an affiliation in Medicare Care Compare.
-
- Internal Medicine Physician
- Florence, SC
- NPI 1497231211
Nursing home
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1540944000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1559088000000",
"number": "1124595863",
"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"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2379 CYPRESS CIR",
"city": "CONWAY",
"state": "SC",
"postal_code": "295268921",
"telephone_number": "843-347-8179"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PRUITTHEALTH - CONWAY, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2018-10-31",
"last_updated": "2019-05-29",
"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_suffix": "Jr."
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "PruittHealth - Conway at Conway Medical Center",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "PruittHealth - Conway at Conway Medical Center",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Conway, SC
- Karissa Marie Proctor, PHARM.D
- Cole Prosser, DMD
- Melissa Courtney Prothro
- Proxsys RX - SC, LLC (The Pharmacy at CMC)
- PRS 5, LLC (Professional Rehabilitation Services)
- Pruitthealth Therapy Services, Inc.
- Angelina Pucciarelli
- Cecelia Catherine Pueschel, RN
- Pshanda Chante Pugh, MA, LPC
- Pamela Pyle, D.O.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.