NPIMap

Organization Active NPI

Pruitthealth Hospice, Inc.

Doing business as PruittHealth Hospice - Macon

  • Community Based Hospice Care Agency
  • Macon, GA
National Provider Identifier
1235177205
Registry record updated Sep 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
Legal business name
PRUITTHEALTH HOSPICE, INC.
Doing business as
PruittHealth Hospice - Macon
Practice address
6060 Lakeside Commons Dr
Macon, GA 31210-5778
Phone
(478) 745-9204
Fax
(478) 745-9321
NPI assigned
Jun 3, 2006
Last updated
Sep 15, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2021

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

Authorized official

Name
Neil L Pruitt Jr.
Title
Chairman and Ceo
Phone
(770) 279-6200

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X NU Primary
Hospice and Palliative Medicine (Internal Medicine) Physician 207RH0002X NU

Addresses

Primary practice location

6060 Lakeside Commons Dr
Macon, GA 31210-5778

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
00697716AMedicaidGA

Other names 1

  • PruittHealth Hospice - Macon Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20060308000176 GA Part A Provider - Hospice 2264344217 Practice locations: Macon, GA
O20190702003113 GA Part B Supplier - Clinic/Group Practice 2264344217 Receives reassigned benefits from 45 practitioners
12 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Watkinsville, GA; Augusta, GA; Valdosta, GA; Union City, GA; Swainsboro, GA; Savannah, GA; Rome, GA; Macon, GA…

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1235177205. Details of each certification follow.

Hospice certification: CCN 111545

Legal name
PRUITTHEALTH HOSPICE INC
Doing business as
PRUITTHEALTH HOSPICE- MACON
Certification status
Active
Provider type (POS)
Hospice
Participating since
Sep 14, 1995
Last certification
Apr 8, 2021
Ownership / control type
Proprietary - Corporation
Organization structure
CorporationProprietary
Incorporated
Oct 14, 1993 in GA
Enrollment address
6060 Lakeside Commons Dr
Macon, GA 31210-5778

Other NPIs with the same Medicare PAC ID 17

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

View all 17

Other NPIs on the same Medicare enrollment 12

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Care Compare: Hospice

Medicare Care Compare
Listed as
Pruitthealth Hospice-MaconCCN 111545 · All quality measures
Ownership
Non-Profit
Certified
Sep 14, 1995
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 12

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

NameRoleSinceShare
United Health Services Inc Organization, Norcross, GA For-profit 5% Or Greater Indirect Ownership Interest Jan 2, 2006 100%
Philip W. Small Individual Corporate DirectorDirector Sep 17, 2013
Pruitthealth Inc Organization, Norcross, GA For-profit 5% Or Greater Direct Ownership Interest Jan 1, 2022
Operational/Managerial Control Jan 7, 2008
Lisa P Hamby Trust Organization, Norcross, GA 5% Or Greater Indirect Ownership Interest Jan 2, 2006 31.65%
Neil Little Pruitt Individual Corporate OfficerChairman and Ceo Jan 2, 2006
Corporate DirectorDirector Nov 5, 2007
Other Nov 15, 2007
Neil L Pruitt Jr Trust Organization, Norcross, GA 5% Or Greater Indirect Ownership Interest Jan 2, 2006
Nancy W Pruitt Individual Corporate OfficerSecretary Jan 2, 2006
Uhs-Pruitt Holdings, Inc. Organization, Norcross, GA For-profit 5% Or Greater Indirect Ownership Interest Jan 2, 2006 100%
Katherine Chapman Individual W-2 Managing EmployeeAdministrator Jul 1, 2014
Thomas R Beddingfield Individual Corporate DirectorDirector Sep 17, 2013
United Health Services of Georgia, Inc. Organization, Norcross, GA For-profit 5% Or Greater Direct Ownership Interest Jan 7, 2008 99%
J Paige Pruitt Trust Organization, Norcross, GA 5% Or Greater Indirect Ownership Interest Jan 2, 2006 31.32%

Facilities with the same owner 123

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

  • Pruitthealth - Ashburn LLC

    dba PruittHealth - Ashburn

    • Skilled Nursing Facility
    • Ashburn, GA
    • NPI 1851347108

    J Paige Pruitt Trust, Lisa P Hamby Trust, Neil L Pruitt Jr Trust, Pruitthealth Inc, Uhs-Pruitt Holdings, Inc., United Health Services Inc, United Health Services of Georgia, Inc.

    CMS ownership
  • Pruitthealth - Athens Heritage LLC

    dba PruittHealth - Athens Heritage

    • Skilled Nursing Facility
    • Athens, GA
    • NPI 1316993769

    J Paige Pruitt Trust, Lisa P Hamby Trust

    CMS ownership
  • Pruitthealth - Augusta Hills LLC

    dba PruittHealth - Augusta Hills

    • Skilled Nursing Facility
    • Augusta, GA
    • NPI 1235186974

    United Health Services Inc

    CMS ownership
  • Pruitthealth - Augusta, LLC

    dba PruittHealth - Augusta

    • Skilled Nursing Facility
    • Augusta, GA
    • NPI 1295908846

    J Paige Pruitt Trust, Lisa P Hamby Trust, Neil L Pruitt Jr Trust, Pruitthealth Inc, Uhs-Pruitt Holdings, Inc., United Health Services Inc, United Health Services of Georgia, Inc.

    CMS ownership
  • Pruitthealth - Austell, LLC

    dba PruittHealth - Austell

    • Skilled Nursing Facility
    • Austell, GA
    • NPI 1386690642

    J Paige Pruitt Trust, Lisa P Hamby Trust, Neil L Pruitt Jr Trust, Pruitthealth Inc, Uhs-Pruitt Holdings, Inc., United Health Services Inc, United Health Services of Georgia, Inc.

    CMS ownership
  • Pruitthealth - Bethany, LLC

    dba PruittHealth - Bethany

    • Skilled Nursing Facility
    • Millen, GA
    • NPI 1184924458

    J Paige Pruitt Trust, Lisa P Hamby Trust, Neil L Pruitt Jr Trust, Pruitthealth Inc, Uhs-Pruitt Holdings, Inc., United Health Services Inc, United Health Services of Georgia, Inc.

    CMS ownership
  • Pruitthealth - Blue Ridge, LLC

    dba PruittHealth - Blue Ridge

    • Skilled Nursing Facility
    • Blue Ridge, GA
    • NPI 1730136599

    Neil L Pruitt Jr Trust, United Health Services Inc, United Health Services of Georgia, Inc.

    CMS ownership
  • Pruitthealth - Brookhaven, LLC

    dba PruittHealth - Brookhaven

    • Skilled Nursing Facility
    • Atlanta, GA
    • NPI 1336196468

    J Paige Pruitt Trust, Lisa P Hamby Trust, Neil L Pruitt Jr Trust, Uhs-Pruitt Holdings, Inc., United Health Services Inc, United Health Services of Georgia, Inc.

    CMS ownership
  • Pruitthealth - Christian City, LLC

    dba Christian City Rehabilitation Center

    • Skilled Nursing Facility
    • Union City, GA
    • NPI 1720221328

    J Paige Pruitt Trust, Lisa P Hamby Trust, Neil L Pruitt Jr Trust, Uhs-Pruitt Holdings, Inc., United Health Services Inc, United Health Services of Georgia, Inc.

    CMS ownership
  • Pruitthealth - Covington LLC

    dba PruittHealth - Covington

    • Skilled Nursing Facility
    • Covington, GA
    • NPI 1457797177

    J Paige Pruitt Trust, Lisa P Hamby Trust, Neil L Pruitt Jr Trust, Uhs-Pruitt Holdings, Inc., United Health Services Inc, United Health Services of Georgia, Inc.

    CMS ownership
  • Pruitthealth - Creekside, LLC
    • Skilled Nursing Facility
    • Augusta, GA
    • NPI 1104536077

    United Health Services of Georgia, Inc.

    CMS ownership
  • Pruitthealth - Crestwood, LLC
    • Skilled Nursing Facility
    • Valdosta, GA
    • NPI 1063036200

    J Paige Pruitt Trust, Lisa P Hamby Trust, Neil L Pruitt Jr Trust, United Health Services Inc, United Health Services of Georgia, Inc.

    CMS ownership
View all 123

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

Affiliated clinicians 11

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": "1149292800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1631664000000",
    "number": "1235177205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1626 JEURGENS CT",
            "address_2": "LEGAL DEPT",
            "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": "6060 LAKESIDE COMMONS DR",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312105778",
            "telephone_number": "478-745-9204",
            "fax_number": "478-745-9321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRUITTHEALTH HOSPICE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-03",
        "last_updated": "2021-09-15",
        "certification_date": "2021-09-15",
        "status": "A",
        "authorized_official_last_name": "PRUITT",
        "authorized_official_first_name": "NEIL",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CHAIRMAN AND CEO",
        "authorized_official_telephone_number": "770-279-6200",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207RH0002X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hospice and Palliative Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00697716A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PruittHealth Hospice - Macon",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "PruittHealth Hospice - Macon",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Macon, GA

Sources for this page

Verify at the official NPI Registry.