Lowndes County Health Services LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

1-092-936 Issued in GA

Legal business name

LOWNDES COUNTY HEALTH SERVICES LLC

Doing business as

PruittHealth - Crestwood

Practice address

415 Pendleton PL
Valdosta, GA 31602-2632

Phone

(229) 242-6868

Fax

(229) 242-5357

NPI assigned

Jun 5, 2006

Organization subpart

No

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 of Manager

Phone

(770) 279-6200

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• PruittHealth - Crestwood Doing business as

Locations

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

{
    "created_epoch": "1149465600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1399593600000",
    "number": "1295774222",
    "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",
            "fax_number": "770-931-5278"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 PENDLETON PL",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316022632",
            "telephone_number": "229-242-6868",
            "fax_number": "229-242-5357"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOWNDES COUNTY HEALTH SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-05",
        "last_updated": "2014-05-09",
        "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 OF MANAGER",
        "authorized_official_telephone_number": "770-279-6200",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "GA",
            "license": "1-092-936",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00140764A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PruittHealth - Crestwood",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Tyler Stephen Lowe, LAT, ATC
• Kelly Lowery, DNP, FNP-BC
• Lacey L Lowery, MED, CCC-SLP
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• Lowndes County Health Services, LLC
• Lowndes County Health Services, LLC
• Lowndes County Health Services, LLC
• Lowndes County Public Schools

• Skilled Nursing Facility in Valdosta, GA
• Providers in Valdosta, 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 May 9, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.