Pruitthealth - Ocilla, LLC
Organization Active NPI Skilled Nursing Facility · Ocilla, GA
NPI 1144567488 · NPPES record last updated Jun 27, 2014
Key facts
- NPI
- 1144567488
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Skilled Nursing Facility 314000000X
- License
- 1-077-1773 (GA)
- Legal business name
- PRUITTHEALTH - OCILLA, LLC
- Practice address
- 209 W Hudson St
Ocilla, GA 31774-1235 - Phone
- (229) 468-9431
- NPI assigned
- Jan 7, 2013
- Organization subpart
- No
Authorized official
- Name
- Neil L Pruitt Jr.
- Title
- Chairman and Ceo of Manager
- Phone
- (770) 279-6200
Facilities with the same owner 123
Practitioners 2
-
James Stanley Sinclair, M.D.
Affiliated clinicians 2
-
James Stanley Sinclair, M.D.
Medicare Care Compare: Nursing home
- Listed as
- Pruitthealth - Ocilla
- Overall star rating
- ★★★☆☆ 3 of 5
- Health inspections
- ★★★★☆ 4 of 5
- Staffing
- ★★☆☆☆ 2 of 5
- Quality measures
- ★☆☆☆☆ 1 of 5
- Type
- Medicare and Medicaid
- Ownership
- For profit - Corporation
- Certified
- Sep 16, 1996
- Medicare certification status
- Active
- Certified beds
- 83 · 64.6 residents per day on average
- Chain
- Pruitthealth
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
Skilled nursing facility certification: CCN 115608
- Legal name
- PRUITTHEALTH - OCILLA, LLC
- Doing business as
- PRUITTHEALTH - OCILLA
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Sep 16, 1996
- Last certification
- Jan 26, 2023
- Beds
- 83
- Ownership / control type
- Corporation
- Organization structure
- LLC · Proprietary
- Incorporated
- May 21, 2012 in GA
- Enrollment address
- 209 W Hudson St
Ocilla, GA 31774-1235 - Nursing home name
- PRUITTHEALTH - OCILLA
- Affiliated entity
- PRUITTHEALTH
All disclosed owners & managing parties 9
| Name | Role | Since | Share |
|---|---|---|---|
| Delores Scroggs |
W-2 Managing Employee |
Nov 27, 2021 | 100% |
| United Health Services Inc |
5% Or Greater Indirect Ownership Interest | May 21, 2012 | 100% |
| Pruitthealth Inc |
Other | May 21, 2012 | |
| Lisa P Hamby Trust |
5% Or Greater Indirect Ownership Interest | May 21, 2012 | 26.13% |
| Neil Little Pruitt |
Corporate Officer |
May 21, 2012 | 100% |
| Corporate Director |
May 21, 2012 | 100% | |
| Other |
May 21, 2012 | 100% | |
| Neil L Pruitt Jr Trust |
5% Or Greater Indirect Ownership Interest | May 21, 2012 | 35.2% |
| Uhs-Pruitt Holdings, Inc. |
5% Or Greater Indirect Ownership Interest | May 21, 2012 | 100% |
| United Health Services of Georgia, Inc. |
5% Or Greater Direct Ownership Interest | May 21, 2012 | 99% |
| J Paige Pruitt Trust |
5% Or Greater Indirect Ownership Interest | May 21, 2012 | 28.84% |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20130305000635 | GA | Part a Provider - Skilled Nursing Facility | 6305091901 | Practice locations: Ocilla, GA |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | 1-077-1773 | GA | Yes |
Addresses
Primary practice location
209 W Hudson St
Ocilla, GA 31774-1235
Mailing address
1626 Jeurgens CT
Norcross, GA 30093-2219
Phone (770) 279-6200
Other names
- PruittHealth - Ocilla
Other providers in Ocilla, GA
- Osceola Health Care, Inc
- Dana P Paulk
- Mary Paulk
- Kayla Phillips
- John D Price
- Caleb Patrick Ray
- Robert Juran Ray
- Amy Robinson
- Arturo Natada Ruanto
- Ashfaq Saiyed
All providers in Ocilla, 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 Jun 27, 2014. 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.