Organization Active NPI

Pruitthealth - Virginia Park, LLC

  • Skilled Nursing Facility
  • Atlanta, GA
National Provider Identifier
1134500754
Registry record updated Jun 10, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
PRUITTHEALTH - VIRGINIA PARK, LLC
Practice address
1000 Briarcliff Rd NE
Atlanta, GA 30306-2618
Phone
(404) 875-6456
Fax
(404) 874-4606
NPI assigned
Jun 10, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2015

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)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

1000 Briarcliff Rd NE
Atlanta, GA 30306-2618

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
000140401AMedicaidGA

Other names 1

  • PruittHealth - Virginia Park Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150924000569 GA Part A Provider - Skilled Nursing Facility 6709194798 Practice locations: Atlanta, GA

Skilled nursing facility certification: CCN 115531

Legal name
PRUITTHEALTH - VIRGINIA PARK, LLC
Doing business as
PRUITTHEALTH - VIRGINIA PARK
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF distinct part
Participating since
Sep 15, 1992
Last certification
Jun 12, 2025
Beds
128
Ownership / control type
Limited Liability Corporation
Multi-facility organization
Pruitthealth
Organization structure
LLCProprietary
Incorporated
Feb 3, 2015 in GA
Enrollment address
1000 Briarcliff Rd NE
Atlanta, GA 30306-2618
Nursing home name
PRUITTHEALTH - VIRGINIA PARK
Affiliated entity
PRUITTHEALTH

Care Compare: Nursing home

Medicare Care Compare
Listed as
Pruitthealth - Virginia ParkCCN 115531
Overall star rating
3 of 5
Health inspections
3 of 5
Staffing
2 of 5
Quality measures
4 of 5
Type
Medicare and Medicaid
Ownership
For profit - Limited Liability company
Certified
Sep 15, 1992
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
128117.6 residents per day on average
Chain
Pruitthealth95 facilities in the chain
Penalties (3 years)
1Fines totaling $8,788

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
11D1078935Pruitthealth-Virginia Park, LLC1000 Briarcliff Road, NE, Atlanta, GA 30306Certificate of waiverApr 6, 2028

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 9

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

NameRoleSinceShare
United Health Services Inc Organization, Norcross, GA Corporation, For-profit 5% Or Greater Indirect Ownership Interest Feb 3, 2015 100%
Pruitthealth Inc Organization, Toccoa, GA Corporation Other Feb 3, 2015 100%
Lisa P Hamby Trust Organization, Norcross, GA 5% Or Greater Indirect Ownership Interest Feb 3, 2015 28.84%
Neil Little Pruitt Individual Corporate Officer Feb 3, 2015
Corporate Director Feb 3, 2015
Neil L Pruitt Jr Trust Organization, Norcross, GA 5% Or Greater Indirect Ownership Interest Feb 3, 2015 35.2%
Anthony M Grant Individual W-2 Managing EmployeeFacility Administrator Dec 29, 2019 100%
Uhs-Pruitt Holdings, Inc. Organization, Norcross, GA Corporation, For-profit 5% Or Greater Indirect Ownership Interest Feb 3, 2015 100%
United Health Services of Georgia, Inc. Organization, Norcross, GA Created for acquisition, Corporation, For-profit 5% Or Greater Direct Ownership Interest Feb 3, 2015 99%
J Paige Pruitt Trust Organization, Norcross, GA 5% Or Greater Indirect Ownership Interest Feb 3, 2015 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 2

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": "1433894400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1433894400000",
    "number": "1134500754",
    "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": "1000 BRIARCLIFF RD NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303062618",
            "telephone_number": "404-875-6456",
            "fax_number": "404-874-4606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRUITTHEALTH - VIRGINIA PARK, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-10",
        "last_updated": "2015-06-10",
        "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": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000140401A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PruittHealth - Virginia Park",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.