NPIMap

Organization Active NPI

Park Springs, LLC

Doing business as Pebblebrook Health Center at Park Springs

  • Skilled Nursing Facility
  • Stone Mountain, GA
National Provider Identifier
1184605693
Registry record updated May 2, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
1-044-1825 Issued in GA
Legal business name
PARK SPRINGS, LLC
Doing business as
Pebblebrook Health Center at Park Springs
Practice address
5610 New Burmuda Rd
Stone Mountain, GA 30087
Phone
(770) 879-4330
Fax
(770) 879-7330
NPI assigned
Nov 10, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 2, 2019

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

Authorized official

Name
Mr. Kevin W. Isakson
Title
Manager
Phone
(404) 932-6552

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X 044-03-031-1 GA
Skilled Nursing Facility 314000000X 1-044-1825 GA Primary

Addresses

Primary practice location

5610 New Burmuda Rd
Stone Mountain, GA 30087

Mailing address

500 Springhouse Circle
Stone Mountain, GA 30087-6718
Phone (770) 879-4330

Other names 1

  • PEBBLEBROOK HEALTH CENTER AT PARK SPRINGS Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140102001638 GA Part A Provider - Skilled Nursing Facility 7810961380 Practice locations: Stone Mountain, GA

Skilled nursing facility certification: CCN 115694

Legal name
PARK SPRINGS LLC
Doing business as
PEBBLEBROOK HEALTH CENTER AT PARK SPRINGS
Certification status
Active
Provider type (POS)
Nursing home – SNF (Medicare) only
Participating since
May 27, 2005
Last certification
May 1, 2025
Beds
60
Ownership / control type
Limited Liability Corporation
Multi-facility organization
The Terraces at Peachtree Hills Place
Organization structure
LLCProprietary
Enrollment address
5610 New Bermuda Rd
Stone Mountain, GA 30087-4004
Nursing home name
PEBBLEBROOK HEALTH CENTER AT PARK SPRINGS

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
Pebblebrook Health Center at Park SpringsCCN 115694 · All quality measures
Overall star rating
4 of 5
Health inspections
3 of 5
Staffing
5 of 5
Quality measures
3 of 5
Type
Medicare
Ownership
For profit - Limited Liability company
Certified
May 27, 2005
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
6036.7 residents per day on average

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
11D1035559Pebblebrook Health Center at Park Springs5610 New Bermuda Road, Stone Mountain, GA 30087Certificate of waiverJan 4, 2027

National Provider Directory

National Provider Directory

Locations

600 Springhouse Cir
Stone Mountain, GA 30087
Phone (678) 684-3870

Ownership & related parties

All disclosed owners & managing parties 25

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

NameRoleSinceShare
Anderson Public Relations Organization, Atlanta, GA LLC, For-profit Adp of the SNF Mar 30, 2020
Kevin Isakson Individual Corporate Officer Mar 11, 2003
Managing Control - Governing BodyManager Mar 11, 2003
Indirect Ownership Interest Mar 11, 2003 4.5%
Jeffrey Scott Helms Individual Operational/Managerial Control Oct 1, 2018
Isakson/Barnhart Retirement Development Co Organization, Marietta, GA LLC, For-profit, Owned by another organization or individual Direct Ownership Interest Mar 12, 2003 50%
Melody K. Godwin Individual Operational/Managerial Control Apr 1, 2022
Adp of the SNF Apr 1, 2022
Transperfect Health Corp Organization, New York, NY Corporation, For-profit Adp of the SNF Jan 1, 2024
Truist Bank Organization, Atlanta, GA Financial institution, For-profit 5% Or Greater Mortgage Interest Feb 1, 2016 45%
5% Or Greater Security Interest Feb 4, 2016 45%
Nutritious Lifestyles, Inc. Organization, Orlando, FL LLC, For-profit Adp of the SNF Jan 1, 2022
David Barnhart Individual Managing Control - Governing BodyManager Mar 11, 2003
Indirect Ownership Interest Mar 11, 2003 26.32%
Ottley Properties, LLC Organization, Metairie, LA LLC, For-profit, Owned by another organization or individual Indirect Ownership Interest Mar 12, 2003 18.75%
Pitot Ottley, LLC Organization, Metairie, LA LLC, For-profit, Owned by another organization or individual Indirect Ownership Interest Jan 1, 2023 18.75%
Life Care Services LLC Organization, Des Moines, IA LLC, Consulting firm, For-profit Adp of the SNF Jul 1, 2014
Standard Park Springs LLC Organization, New Orleans, LA LLC, For-profit, Owned by another organization or individual Direct Ownership Interest Mar 12, 2003 12.5%
Michael Bright White Childrens Trust Organization, Metairie, LA Indirect Ownership Interest Mar 12, 2003 15.16%
Standard Mortgage Corporation Organization, New Orleans, LA Corporation, For-profit, Owned by another organization or individual Indirect Ownership Interest Mar 12, 2003 10.63%
Cruden Capital LLC Organization, Roswell, GA LLC, For-profit, Owned by another organization or individual Direct Ownership Interest Mar 12, 2003 12.5%
Isakson Living, Inc. Organization, Roswell, GA Corporation, Management services company, For-profit Operational/Managerial Control Jul 1, 2014
Adp of the SNF Jun 2, 2025
Khurram Khan Individual Operational/Managerial Control Oct 1, 2022
Adp of the SNF Jun 2, 2025
Amanda Levato Individual Operational/Managerial Control Jun 20, 2023
Adp of the SNF Jun 2, 2025
Idea Associates Organization, Atlanta, GA Corporation, For-profit Adp of the SNF May 1, 2017
Shiftmed, LLC Organization, MC Lean, VA LLC, For-profit Adp of the SNF Jan 1, 2022
White-Parkside Stone Mountain LLC Organization, Metairie, LA LLC, For-profit, Owned by another organization or individual Direct Ownership Interest Mar 12, 2003 25%
Mark Berger Individual Operational/Managerial Control Jan 1, 2023
Adp of the SNF Jan 1, 2023
Edwin Isakson Individual Managing Control - Governing BodyManager Mar 11, 2003
Indirect Ownership Interest Mar 11, 2003 26.32%
Smith and Howard Advisory LLC Organization, Atlanta, GA LLC, For-profit Adp of the SNF Jan 1, 2018

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 1

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

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Affiliated clinicians 5

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": "1131580800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1556755200000",
    "number": "1184605693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 SPRINGHOUSE CIRCLE",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "300876718",
            "telephone_number": "770-879-4330",
            "fax_number": "770-879-7330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5610 NEW BURMUDA RD",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "30087",
            "telephone_number": "770-879-4330",
            "fax_number": "770-879-7330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARK SPRINGS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-10",
        "last_updated": "2019-05-02",
        "status": "A",
        "authorized_official_last_name": "ISAKSON",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_middle_name": "W.",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "404-932-6552",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "GA",
            "license": "044-03-031-1",
            "primary": false
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "GA",
            "license": "1-044-1825",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PEBBLEBROOK HEALTH CENTER AT PARK SPRINGS",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "PEBBLEBROOK HEALTH CENTER AT PARK SPRINGS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Stone Mountain, GA

Sources for this page

Verify at the official NPI Registry.