NPIMap

Organization Active NPI

Abercorn Rehabilitation Center, LLC

  • Skilled Nursing Facility
  • Savannah, GA
National Provider Identifier
1164848396
Registry record updated Sep 25, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
1-025-2037 Issued in GA
Legal business name
ABERCORN REHABILITATION CENTER, LLC
Practice address
11800 Abercorn St
Savannah, GA 31419-1908
Phone
(912) 925-4402
Fax
(912) 920-4756
NPI assigned
Mar 12, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2014

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

Authorized official

Name
Mr. R. Mark Cronquist
Title
Manager
Phone
(404) 574-2100

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X
Skilled Nursing Facility 314000000X 1-025-2037 GA Primary

Addresses

Primary practice location

11800 Abercorn St
Savannah, GA 31419-1908

Mailing address

5887 Glenridge Dr
Suite 150
Atlanta, GA 30328-5574
Phone (404) 574-2100

Other identifiers 1

IdentifierTypeStateIssuer
003147910AMedicaidGA

Other names 1

  • Abercorn Rehabilitation Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140425001830 GA Part A Provider - Skilled Nursing Facility 5193958254 Practice locations: Savannah, GA

Skilled nursing facility certification: CCN 115132

Legal name
ABERCORN REHABILITATION CENTER LLC
Doing business as
ABERCORN REHABILITATION CENTER
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF distinct part
Participating since
May 15, 1972
Last certification
Jan 24, 2025
Beds
100
Ownership / control type
Corporation
Multi-facility organization
SOUTHERN HEALTHCARE MANAGEMENT
Organization structure
LLCProprietary
Enrollment address
11800 Abercorn St
Savannah, GA 31419-1908
Nursing home name
ABERCORN REHABILITATION CENTER
Affiliated entity
SOVEREIGN HEALTHCARE HOLDINGS

Care Compare: Nursing home

Medicare Care Compare
Listed as
Abercorn Rehabilitation CenterCCN 115132
Overall star rating
1 of 5
Health inspections
2 of 5
Staffing
1 of 5
Quality measures
4 of 5
Type
Medicare and Medicaid
Ownership
For profit - Corporation
Certified
May 15, 1972
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
10087.5 residents per day on average
Chain
Sovereign Healthcare Holdings43 facilities in the chain
Penalties (3 years)
1Fines totaling $10,868

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
11D0711039Abercorn Rehabilitation Center, LLC11800 Abercorn Street, Savannah, GA 31419Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory

Ownership & 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.

NameRoleSinceShare
Organization, Tustin, CA Corporation Adp of the SNF May 1, 2014
Southern Healthcare Management LLC Organization, Casselberry, FL LLC, Management services company, For-profit Operational/Managerial Control May 1, 2014 100%
Adp of the SNF Apr 15, 2025
Individual Adp of the SNF Jun 8, 2017
Chido Mukwindidza Individual Operational/Managerial Control Nov 24, 2025
Adp of the SNF Nov 24, 2025
Organization, Tustin, CA LLC Adp of the SNF May 1, 2014
Michelle Kelly Individual Corporate OfficerChief Financial Officer Feb 1, 2018 100%
Adp of the SNF Feb 1, 2018
Donald K Melton Individual Corporate OfficerChief Financial Officer May 1, 2014 100%
Adp of the SNF May 1, 2014
Individual Adp of the SNF May 1, 2014
Individual Adp of the SNF Sep 1, 2021
Organization, Casselberry, FL LLC Adp of the SNF Apr 15, 2025
Royce M Cronquist Individual Corporate OfficerChief Executive Officer Feb 1, 2018 100%
Adp of the SNF Feb 1, 2018
Individual Adp of the SNF Jun 15, 2023
Individual Adp of the SNF May 1, 2014
Indirect Ownership Interest May 1, 2014 4.9%
Organization, Tustin, CA LLC Adp of the SNF May 1, 2014
John J Notermann Business TR Organization, Casselberry, FL Indirect Ownership Interest Nov 12, 2017 80.9%
Sovereign Carolina Holdings LLC Organization, Atlanta, GA LLC, Holding company, For-profit, Owned by another organization or individual Direct Ownership Interest Mar 6, 2014 100%
Organization, Springfield, MO Adp of the SNF Apr 15, 2025
Vamsi Kanagala Individual Operational/Managerial Control Jan 1, 2025
Adp of the SNF Jan 1, 2025
Cronquist 2015 Family TR Organization, Atlanta, GA Indirect Ownership Interest Dec 31, 2015 14.2%
Organization, Casselberry, FL LLC Adp of the SNF Apr 15, 2025

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 41

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

View all 41

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": "1394582400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1411603200000",
    "number": "1164848396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5887 GLENRIDGE DR",
            "address_2": "SUITE 150",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303285574",
            "telephone_number": "404-574-2100",
            "fax_number": "404-574-2105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11800 ABERCORN ST",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314191908",
            "telephone_number": "912-925-4402",
            "fax_number": "912-920-4756"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ABERCORN REHABILITATION CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-03-12",
        "last_updated": "2014-09-25",
        "status": "A",
        "authorized_official_last_name": "CRONQUIST",
        "authorized_official_first_name": "R.",
        "authorized_official_middle_name": "MARK",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "404-574-2100",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "GA",
            "license": "1-025-2037",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003147910A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Abercorn Rehabilitation Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Savannah, GA

Sources for this page

Verify at the official NPI Registry.