Organization Active NPI

Pruitthealth - Estill, LLC

Doing business as PruittHealth - Estill

  • Skilled Nursing Facility
  • Estill, SC
National Provider Identifier
1174504203
Registry record updated Jun 30, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
NCF922 Issued in SC
Legal business name
PRUITTHEALTH - ESTILL, LLC
Doing business as
PruittHealth - Estill
Practice address
252 Liberty Street South
Estill, SC 29918-3311
Phone
(803) 625-3852
Fax
(803) 625-2441
NPI assigned
Nov 7, 2005
Last updated
Jun 30, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2014

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

Authorized official

Name
Mr. Neil Little Pruitt Jr.
Title
Chairman/Ceo of MGR
Phone
(770) 279-6200

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X NCF922 SC Primary

Addresses

Primary practice location

252 Liberty Street South
Estill, SC 29918-3311

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
0585NHMedicaidSC

Other names 1

  • PruittHealth - Estill Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070117000053 SC Part A Provider - Skilled Nursing Facility 7012918170 Practice locations: Estill, SC

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1174504203. Details of each certification follow.

Skilled nursing facility certification: CCN 425315

Legal name
PRUITTHEALTH - ESTILL, LLC
Doing business as
PRUITTHEALTH - ESTILL
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Sep 27, 1991
Last certification
Apr 29, 2025
Beds
88
Ownership / control type
Limited Liability Corporation
Multi-facility organization
PruittHealth Incorporate
Organization structure
LLCProprietary
Enrollment address
252 Liberty Ave S
Estill, SC 29918-3388
Nursing home name
PRUITTHEALTH- ESTILL
Affiliated entity
PRUITTHEALTH

Care Compare: Nursing home

Medicare Care Compare
Listed as
PruittHealth- EstillCCN 425315 · All quality measures
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
For profit - Limited Liability company
Certified
Sep 27, 1991
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
8876.3 residents per day on average
Chain
Pruitthealth95 facilities in the chain
Penalties (3 years)
1Fines totaling $7,745

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
42D0873449Pruitthealth Estill, LLC252 Liberty Avenue South, Estill, SC 29918Certificate of waiverApr 3, 2027

National Provider Directory

National Provider Directory

Locations

252 Liberty Ave S
Estill, SC 29918
Phone (803) 625-3852

Ownership & related parties

All disclosed owners & managing parties 22

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

NameRoleSinceShare
Individual Adp of the SNF Nov 11, 2019
Vlastimil Smetka Individual Operational/Managerial Control May 25, 2024
Adp of the SNF Feb 18, 2026
Organization, Norcross, GA Adp of the SNF Aug 18, 2020
Indirect Ownership Interest Aug 12, 2020 1.62%
NWP 2020 Child TR Fbo Lisa P Hamby Organization, Norcross, GA Adp of the SNF Aug 12, 2020
Indirect Ownership Interest Aug 12, 2020 2.4%
United Health Services Inc Organization, Norcross, GA Created for acquisition, Corporation, Holding company, Owned by another organization or individual Indirect Ownership Interest Nov 27, 2013 100%
Philip W. Small Individual Managing Control - Governing BodyDirector Nov 27, 2013
Individual Adp of the SNF Nov 27, 2013
Lisa P Hamby Trust Organization, Norcross, GA Adp of the SNF Aug 12, 2020
Indirect Ownership Interest Aug 12, 2020 22.98%
Neil Little Pruitt Individual Operational/Managerial Control Nov 27, 2013
Direct Ownership Interest Nov 27, 2013 1%
Individual Adp of the SNF Nov 27, 2013
Bryan a Davis Individual Operational/Managerial Control Mar 2, 2025
Adp of the SNF Mar 28, 2025
United Health Services of South Carolina Inc Organization, Norcross, GA Corporation, For-profit, Owned by another organization or individual Direct Ownership Interest Nov 27, 2013 99%
Neil L Pruitt Jr Trust Organization, Norcross, GA Adp of the SNF Aug 12, 2020
Indirect Ownership Interest Aug 12, 2020 42.86%
NWP 2020 Child TR Fbo Neil L Pruitt Jr Organization, Norcross, GA Adp of the SNF Aug 12, 2020
Indirect Ownership Interest Aug 12, 2020 6.29%
NWP 2020 Child TR Fbo J Paige Pruitt Organization, Norcross, GA Adp of the SNF Aug 12, 2020
Indirect Ownership Interest Aug 12, 2020 2.4%
Nancy W Pruitt Individual Managing Control - Governing BodySecretary Nov 27, 2013
Pruitthealth Consulting Services Inc Organization, Norcross, GA Corporation Adp of the SNF Nov 26, 2013
Uhs-Pruitt Holdings, Inc. Organization, Norcross, GA Holding company 5% Or Greater Indirect Ownership Interest Sep 6, 2006 100%
Estill Healthcare Properties Inc Organization, Norcross, GA Corporation Adp of the SNF Jul 30, 2010
United Health Services of Georgia, Inc. Organization, Norcross, GA Corporation, Holding company Indirect Ownership Interest Nov 27, 2013 100%
Pruitt Properties Inc Organization, Norcross, GA Corporation Indirect Ownership Interest Aug 12, 2020 100%
J Paige Pruitt Trust Organization, Norcross, GA Adp of the SNF Jun 22, 2021
Indirect Ownership Interest Jun 22, 2021 21.44%

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 106

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

View all 106

Practitioners & affiliated clinicians

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": "1131321600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1404086400000",
    "number": "1174504203",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "252 LIBERTY STREET SOUTH",
            "city": "ESTILL",
            "state": "SC",
            "postal_code": "299183311",
            "telephone_number": "803-625-3852",
            "fax_number": "803-625-2441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRUITTHEALTH - ESTILL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-07",
        "last_updated": "2014-06-30",
        "status": "A",
        "authorized_official_last_name": "PRUITT",
        "authorized_official_first_name": "NEIL",
        "authorized_official_middle_name": "LITTLE",
        "authorized_official_title_or_position": "CHAIRMAN/CEO OF MGR",
        "authorized_official_telephone_number": "770-279-6200",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "SC",
            "license": "NCF922",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0585NH",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PruittHealth - Estill",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Estill, SC

Sources for this page

Verify at the official NPI Registry.