Active NPI
Fairburn Heights of Journey LLC
- Skilled Nursing Facility
- Fairburn, GA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- Legal business name
- FAIRBURN HEIGHTS OF JOURNEY LLC
- Practice address
- 178 W Campbellton St
Fairburn, GA 30213-1219 - Phone
- (770) 964-1320
- Fax
- (770) 969-6177
- NPI assigned
- Sep 12, 2024
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Bernard J McGuinness III
- Title
- Officer
- Phone
- (463) 278-0868
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | Primary |
Addresses
Primary practice location
178 W Campbellton St
Fairburn, GA 30213-1219
Mailing address
178 W Campbellton St
Fairburn, GA 30213-1219
Phone (770) 964-1320
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20250519002161 | GA | Part A Provider - Skilled Nursing Facility | 7416475926 | Practice locations: Fairburn, GA |
Skilled nursing facility certification: CCN 115298
- Legal name
- FAIRBURN HEIGHTS OF JOURNEY LLC
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF distinct part
- Participating since
- May 7, 1982
- Last certification
- Aug 5, 2024
- Beds
- 120
- Ownership / control type
- Limited Liability Corporation
- Multi-facility organization
- JOURNEY HEALTHCARE
- Organization structure
- LLC
- Enrollment address
- 178 W Campbellton St
Fairburn, GA 30213-1219 - Nursing home name
- FAIRBURN HEIGHTS OF JOURNEY LLC
- Affiliated entity
- JOURNEY HEALTHCARE
Care Compare: Nursing home
Medicare Care Compare- Listed as
- Fairburn Heights of Journey LLC
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- For profit - Limited Liability company
- Certified
- May 7, 1982
- Medicare certification status
- Active
- Certified beds
- 120
- Chain
- Journey Healthcare
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 11D0257191 | Fairburn Heights | Certificate of waiver | Aug 31, 2026 |
National Provider Directory
National Provider DirectoryOwnership & related parties
All disclosed owners & managing parties 30
As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.
| Name | Role | Since | Share |
|---|---|---|---|
| Adp of the SNF | Nov 1, 2024 | ||
| Blue Ocean Trust | Indirect Ownership Interest | Nov 1, 2024 | 31.7% |
| Edna Phillips | Operational/Managerial Control | Nov 1, 2024 | |
| Adp of the SNF | Nov 1, 2024 | ||
| Nikki Sillings | Operational/Managerial Control | Jan 13, 2025 | |
| Adp of the SNF | Jan 13, 2025 | ||
| Ajoj Holdings LLC | Indirect Ownership Interest | Nov 1, 2024 | 33.33% |
| Adp of the SNF | Nov 1, 2024 | ||
| Jody Omara | Operational/Managerial Control | Nov 1, 2024 | |
| Adp of the SNF | Nov 1, 2024 | ||
| Adp of the SNF | Nov 1, 2024 | ||
| Journey Ox Ga Management LLC | Operational/Managerial Control | Nov 1, 2024 | |
| Adp of the SNF | Nov 1, 2024 | ||
| Adp of the SNF | Nov 1, 2024 | ||
| Shasam Holdings LLC | Indirect Ownership Interest | Nov 1, 2024 | 33.33% |
| Summit Fairburn LLC | Adp of the SNF | Nov 1, 2024 | |
| Antonio Jones | Operational/Managerial Control | Nov 18, 2024 | |
| Adp of the SNF | Nov 18, 2024 | ||
| Pamela Scandrett | Operational/Managerial Control | Nov 1, 2024 | |
| Adp of the SNF | Nov 1, 2024 | ||
| Adp of the SNF | Nov 1, 2024 | ||
| Indirect Ownership Interest | Nov 1, 2024 | 1.63% | |
| Tiffany Davis | Operational/Managerial Control | Nov 1, 2024 | |
| Adp of the SNF | Nov 1, 2024 | ||
| Matthew L Trammell | Operational/Managerial Control | Nov 1, 2024 | |
| Adp of the SNF | Nov 1, 2024 | ||
| Jennifer Johnson | Operational/Managerial Control | Nov 1, 2024 | |
| Adp of the SNF | Nov 1, 2024 | ||
| Bernard J McGuinness | Operational/Managerial Control | Nov 1, 2024 | |
| Managing Control - Governing Body | Nov 1, 2024 | ||
| Adp of the SNF | Nov 1, 2024 | ||
| Indirect Ownership Interest | Nov 1, 2024 | 1.63% | |
| Journey Ox Ga Healthcare Holdings LLC | Indirect Ownership Interest | Nov 1, 2024 | 100% |
| 3 Bees Holdings LLC | Indirect Ownership Interest | Nov 1, 2024 | 33.3% |
| Cameron Conrad | Operational/Managerial Control | Nov 1, 2024 | |
| Adp of the SNF | Nov 1, 2024 | ||
| Adp of the SNF | Nov 1, 2024 | ||
| Shasam Family Trust | Indirect Ownership Interest | Nov 1, 2024 | 31.7% |
| Terence Frinks | Operational/Managerial Control | Nov 1, 2024 | |
| Adp of the SNF | Nov 1, 2024 | ||
| Journey Ox of Ga LLC | Direct Ownership Interest | Nov 1, 2024 | 100% |
| Richard Bilbo | Operational/Managerial Control | Nov 20, 2024 | |
| Adp of the SNF | Nov 20, 2024 | ||
| Bees Family Irrevocable Trust | Indirect Ownership Interest | Nov 1, 2024 | 31.7% |
| Indirect Ownership Interest | Nov 1, 2024 | 1.63% |
Owners & managing parties with NPI records 1
Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.
-
- Family Medicine Physician
- Tucker, GA
- NPI 1285761833
Adp of the SNF, Operational/Managerial Control
Facilities with the same owner 8
Facilities that share an organizational owner with 5% or greater ownership or operational control.
-
- Skilled Nursing Facility
- Calhoun, GA
- NPI 1285467167
Journey Ox Ga Management LLC
-
- Skilled Nursing Facility
- Cartersville, GA
- NPI 1518793710
Journey Ox Ga Management LLC
-
- Skilled Nursing Facility
- Dublin, GA
- NPI 1154154086
Journey Ox Ga Management LLC
-
- Skilled Nursing Facility
- Jasper, GA
- NPI 1437985637
Journey Ox Ga Management LLC
-
- Skilled Nursing Facility
- Chatsworth, GA
- NPI 1659104537
Journey Ox Ga Management LLC
-
- Skilled Nursing Facility
- Stone Mountain, GA
- NPI 1154157352
Journey Ox Ga Management LLC
-
- Skilled Nursing Facility
- Decatur, GA
- NPI 1528894714
Journey Ox Ga Management LLC
-
- Skilled Nursing Facility
- Flowery Branch, GA
- NPI 1962238162
Journey Ox Ga Management LLC
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Family Medicine Physician
- Tucker, GA
- NPI 1285761833
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": "1726099200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1726099200000",
"number": "1255167458",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "178 W CAMPBELLTON ST",
"city": "FAIRBURN",
"state": "GA",
"postal_code": "302131219",
"telephone_number": "770-964-1320",
"fax_number": "770-969-6177"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "178 W CAMPBELLTON ST",
"city": "FAIRBURN",
"state": "GA",
"postal_code": "302131219",
"telephone_number": "770-964-1320",
"fax_number": "770-969-6177"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "FAIRBURN HEIGHTS OF JOURNEY LLC",
"organizational_subpart": "NO",
"enumeration_date": "2024-09-12",
"last_updated": "2024-09-12",
"certification_date": "2024-09-12",
"status": "A",
"authorized_official_last_name": "MCGUINNESS",
"authorized_official_first_name": "BERNARD",
"authorized_official_middle_name": "J",
"authorized_official_title_or_position": "OFFICER",
"authorized_official_telephone_number": "463-278-0868",
"authorized_official_name_suffix": "III"
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Fairburn, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.