Stevens Park Health and Rehabilitation Center LLC
Organization Active NPI Skilled Nursing Facility · Augusta, GA
NPI 1154558690 · NPPES record last updated Sep 28, 2023
Key facts
- NPI
- 1154558690
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Skilled Nursing Facility 314000000X
- License
- 1-121-1951 (GA)
- Legal business name
- STEVENS PARK HEALTH AND REHABILITATION CENTER LLC
- Practice address
- 820 Stevens Creek Rd
Augusta, GA 30907-9251 - Phone
- (478) 621-2100
- NPI assigned
- Jun 11, 2009
- Organization subpart
- No
Authorized official
- Name
- Tina Lane
- Title
- Administrator
- Phone
- (478) 737-0350
Owners & managing parties with NPI records 2
-
Dave A Ringer, MD
-
Ralph Parks Warnock, M.D.
Facilities with the same owner 49
Practitioners 2
-
Dave A Ringer, MD
Affiliated clinicians 1
-
Dave A Ringer, MD
Medicare Care Compare: Nursing home
- Listed as
- Stevens Park Health and Rehabilitation
- Overall star rating
- ★★★★★ 5 of 5
- Health inspections
- ★★★★☆ 4 of 5
- Staffing
- ★★★★★ 5 of 5
- Quality measures
- ★★★★☆ 4 of 5
- Type
- Medicare and Medicaid
- Ownership
- Non profit - Other
- Certified
- Oct 6, 2009
- Medicare certification status
- Active
- Certified beds
- 42 · 39.3 residents per day on average
- Chain
- Ethica Health
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 11D1103010 | Stevens Park Health and Rehabilitation | Certificate of waiver | Jul 30, 2027 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
Skilled nursing facility certification: CCN 115294
- Legal name
- STEVENS PARK HEALTH AND REHABILITATION CENTER LLC
- Doing business as
- STEVENS PARK HEALTH AND REHABILITATION
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Oct 6, 2009
- Last certification
- Feb 18, 2024
- Beds
- 42
- Ownership / control type
- Other Nonprofit
- Multi-facility organization
- HEALTH SCHOLARSHIPS
- Organization structure
- LLC · Non-profit
- Incorporated
- Feb 9, 2009 in GA
- Enrollment address
- 820 Stevens Creek Rd
Augusta, GA 30907-9251 - Nursing home name
- STEVENS PARK HEALTH AND REHABILITATION
- Affiliated entity
- ETHICA HEALTH
All disclosed owners & managing parties 18
| Name | Role | Since | Share |
|---|---|---|---|
| Stevens Park Health and Rehabilitation Center LLC |
Adp of the SNF | Mar 3, 2023 | |
| Paul a Cable |
Corporate Director |
Mar 14, 2003 | 100% |
| Ralph Parks Warnock |
Corporate Director |
Jun 23, 2020 | 100% |
| |
Adp of the SNF | Apr 15, 2025 | |
| Ronnie D Rollins |
Corporate Director |
Mar 14, 2003 | 100% |
| Dave a Ringer |
Operational/Managerial Control | Mar 1, 2025 | |
| Adp of the SNF | Mar 1, 2025 | ||
| Stasha Hubble |
Operational/Managerial Control | Mar 13, 2026 | |
| Kathryn Dennis |
Corporate Director |
Nov 17, 2015 | 100% |
| |
Adp of the SNF | Apr 15, 2025 | |
| |
Adp of the SNF | Jan 1, 2025 | |
| |
Adp of the SNF | Apr 15, 2025 | |
| Clinical Services Inc |
Operational/Managerial Control | Sep 1, 2009 | |
| Adp of the SNF | Apr 15, 2025 | ||
| Community Health Systems Inc |
Indirect Ownership Interest | Sep 1, 2009 | 100% |
| Health Scholarships Inc |
Direct Ownership Interest | Sep 1, 2009 | 100% |
| Tina Lane |
Operational/Managerial Control | May 1, 2023 | |
| Adp of the SNF | Apr 15, 2025 | ||
| Kimberly C Hodges |
Operational/Managerial Control | Sep 1, 2023 | |
| Joseph a Wall |
Corporate Director |
Mar 14, 2003 | 100% |
| Joseph Nichols |
Corporate Director |
Nov 19, 2024 | 100% |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20091209000679 | GA | Part a Provider - Skilled Nursing Facility | 0042359721 | Practice locations: Augusta, GA |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | 1-121-1951 | GA | Yes |
Addresses
Primary practice location
820 Stevens Creek Rd
Augusta, GA 30907-9251
Mailing address
820 Stevens Creek Rd
Augusta, GA 30907-9251
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 003143404A | Medicaid | GA |
Other providers in Augusta, GA
- Keith Raymond Sterett
- Meghan K Sterett
- Ilanit Almog Stern
- Jacob Kobi Stern
- Steven M. Roth, M.D., P.C.
- Jennifer Stevens
- Joshua Blaine Stevens
- Mark R Stevens
- Mildred McCall Stevenson
- Abigail Stewart
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 Sep 28, 2023. 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.