NPIMap

Organization Active NPI

Magnolia Manor of Columbus, Inc.

  • Skilled Nursing Facility
  • Columbus, GA
National Provider Identifier
1164456133
Registry record updated Sep 6, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
240031 Issued in GA
Legal business name
MAGNOLIA MANOR OF COLUMBUS, INC.
Practice address
2000 Warm Springs Rd
Columbus, GA 31904-7932
Phone
(706) 324-0387
Fax
(706) 324-0927
NPI assigned
Jul 10, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mrs. Sibyl P. Bledsoe
Title
Business Office Manager
Phone
(229) 931-5904

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 240031 GA Primary

Addresses

Primary practice location

2000 Warm Springs Rd
Columbus, GA 31904-7932

Mailing address

PO Box 9696
Columbus, GA 31908-9696
Phone (706) 324-0387

Other identifiers 1

IdentifierTypeStateIssuer
00083124AMedicaidGA

Other names 1

  • Nursing Center West Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070412000129 GA Part A Provider - Skilled Nursing Facility 4385747666 Practice locations: Columbus, GA

Skilled nursing facility certification: CCN 115045

Legal name
MAGNOLIA MANOR OF COLUMBUS INC
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Apr 6, 1967
Last certification
Sep 6, 2024
Beds
166
Ownership / control type
Nonprofit Corporation
Multi-facility organization
MAGNOLIA MANOR, INC.
Organization structure
CorporationNon-profit
Incorporated
Oct 12, 2006 in GA
Enrollment address
2000 Warm Springs Rd
Columbus, GA 31904-7932
Nursing home name
MAGNOLIA MANOR OF COLUMBUS NURSING CENTER - WEST
Affiliated entity
MAGNOLIA MANOR SENIOR LIVING

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Nursing home

Medicare Care Compare
Listed as
Magnolia Manor of Columbus Nursing Center - WestCCN 115045
Overall star rating
2 of 5
Health inspections
2 of 5
Staffing
3 of 5
Quality measures
4 of 5
Type
Medicare and Medicaid
Ownership
Non profit - Corporation
Certified
Apr 6, 1967
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
16693.0 residents per day on average
Chain
Magnolia Manor Senior Living5 facilities in the chain
Penalties (3 years)
1Fines totaling $34,431

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory
Tax ID family
Magnolia Manor of Columbus Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 4

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

NameRoleSinceShare
Mark R Todd Individual Corporate DirectorChief Executive Officer Feb 12, 2007
Daron Butler Individual Operational/Managerial ControlAdministrator Oct 1, 2016
Hillery V Fort Individual Corporate DirectorChief Operations Officer Nov 1, 2008
Magnolia Manor Inc Organization, Americus, GA Operational/Managerial Control Jan 1, 2007

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 3

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

Practitioners 1

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": "1152489600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1315267200000",
    "number": "1164456133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9696",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319089696",
            "telephone_number": "706-324-0387",
            "fax_number": "706-324-0927"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 WARM SPRINGS RD",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319047932",
            "telephone_number": "706-324-0387",
            "fax_number": "706-324-0927"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAGNOLIA MANOR OF COLUMBUS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-10",
        "last_updated": "2011-09-06",
        "status": "A",
        "authorized_official_last_name": "BLEDSOE",
        "authorized_official_first_name": "SIBYL",
        "authorized_official_middle_name": "P.",
        "authorized_official_title_or_position": "BUSINESS OFFICE MANAGER",
        "authorized_official_telephone_number": "229-931-5904",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "GA",
            "license": "240031",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00083124A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Nursing Center West",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Columbus, GA

Sources for this page

Verify at the official NPI Registry.