Pine Knoll Cypress LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

PINE KNOLL CYPRESS LLC

Doing business as

Pine Knoll Nursing and Rehabilitation Center

Practice address

156 Pine Knoll Dr
Carrollton, GA 30117-2451

Phone

(770) 832-8243

NPI assigned

Dec 18, 2013

Last updated

Jan 19, 2022By the provider in NPPES

Organization subpart

Yes

Parent organization

CYPRESS SKILLED NURSING LLCAs reported in NPPES

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

Authorized official

Name

Isaac Ovits

Title

Cfo

Phone

(845) 694-6055

Specialties & licenses 1

Addresses

Other names 1

• PINE KNOLL NURSING AND REHABILITATION CENTER Doing business as

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1255752226. Details of each certification follow.

• CCN 115443 Skilled nursing facility · Active · Details

Skilled nursing facility certification: CCN 115443

Legal name

PINE KNOLL CYPRESS LLC

Doing business as

PINE KNOLL NURSING AND REHABILITATION CENTER

Certification status

Active

Provider type (POS)

Nursing home – SNF/NF dual certification

Participating since

Oct 1, 1989

Last certification

Apr 10, 2025

Beds

122

Ownership / control type

Limited Liability Corporation

Multi-facility organization

Cypress Skilled Nursing

Most recent change of ownership

Jul 1, 2025

Organization structure

LLCProprietary

Incorporated

Nov 12, 2013 in GA

Enrollment address

156 Pine Knoll Dr
Carrollton, GA 30117-2451

Listed as

Pine Knoll Path of Journey LLCCCN 115443 · All quality measures

Overall star rating

1 of 5

Health inspections

3 of 5

Staffing

1 of 5

Quality measures

1 of 5

Type

Medicare and Medicaid

Ownership

For profit - Limited Liability company

Certified

Oct 1, 1989

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

122100.5 residents per day on average

Processed by Care Compare on Aug 1, 2026.

Locations

All disclosed owners & managing parties 5

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

Facilities with the same owner 6

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

• Carrollton Cypress LLC

  dba Carrollton Nursing and Rehabilitation Center

  • Skilled Nursing Facility
  • Carrollton, GA
  • NPI 1891116836

  Cypress Operating LLC, Cypress Skilled Nursing LLC

  CMS ownership
• Cedar Valley Cypress LLC

  dba Cedar Valley Nursing and Rehabilitation Center

  • Skilled Nursing Facility
  • Cedartown, GA
  • NPI 1346661386

  Cypress Skilled Nursing LLC

  CMS ownership
• Chestnut Ridge Cypress LLC

  dba Chestnut Ridge Nursing and Rehabilitation Center

  • Skilled Nursing Facility
  • Cumming, GA
  • NPI 1982025920

  Cypress Operating LLC, Cypress Skilled Nursing LLC

  CMS ownership
• Haralson Cypress LLC

  dba Haralson Nursing and Rehabilitation Center

  • Skilled Nursing Facility
  • Bremen, GA
  • NPI 1356762322

  Cypress Operating LLC, Cypress Skilled Nursing LLC

  CMS ownership
• Social Circle Cypress LLC

  dba Social Circle Nursing and Rehabilitation Center

  • Skilled Nursing Facility
  • Social Circle, GA
  • NPI 1780005751

  Cypress Operating LLC, Cypress Skilled Nursing LLC

  CMS ownership
• Universe Cypress LLC

  dba University Nursing and Rehabilitation Center

  • Skilled Nursing Facility
  • Athens, GA
  • NPI 1497176465

  Cypress Operating LLC, Cypress Skilled Nursing LLC

  CMS ownership

Practitioners 2

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.

• Xavier C Moore, MD

  • Internal Medicine Physician
  • Stockbridge, GA
  • NPI 1982787297
  NPD (past)
• Solomon Tafari, M.D.

  • Internal Medicine Physician
  • Decatur, GA
  • NPI 1235128828
  NPD (past)

Affiliated clinicians 1

Clinicians who list this facility as an affiliation in Medicare Care Compare.

• Solomon Tafari, M.D.

  • Internal Medicine Physician
  • Decatur, GA
  • NPI 1235128828

  Nursing home

  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1387324800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1642550400000",
    "number": "1255752226",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "156 PINE KNOLL DR",
            "city": "CARROLLTON",
            "state": "GA",
            "postal_code": "301172451",
            "telephone_number": "770-832-8243"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "156 PINE KNOLL DR",
            "city": "CARROLLTON",
            "state": "GA",
            "postal_code": "301172451",
            "telephone_number": "770-832-8243"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PINE KNOLL CYPRESS LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CYPRESS SKILLED NURSING LLC",
        "enumeration_date": "2013-12-18",
        "last_updated": "2022-01-19",
        "certification_date": "2022-01-19",
        "status": "A",
        "authorized_official_last_name": "OVITS",
        "authorized_official_first_name": "ISAAC",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "845-694-6055"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PINE KNOLL NURSING AND REHABILITATION CENTER",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "PINE KNOLL NURSING AND REHABILITATION CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Phoenix Resource Center, Inc.
• Physical Therapy Complete
• Physicians Choice Dialysis of West Georgia, LLC
• Randall Eric Pierce, MD
• Morgan Lyndell Pike, PTA
• Pine Knoll Path of Journey LLC
• Pinnacle Orthopaedics and Sports Medicine
• Watcoun-Nchinda Edward Pisoh, M.D.
• Maritza Pitelli
• Kelly Hutchinson Pittsley, CRNA

• Skilled Nursing Facility in Carrollton, GA
• Providers in Carrollton, GA by specialty
• Skilled Nursing Facility in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2022; 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.

Verify at the official NPI Registry.