NPIMap

Organization Active NPI

Wynfield Park Health and Rehabilitation LLC

Doing business as Wynfield Park Health and Rehabilitation

  • Skilled Nursing Facility
  • Albany, GA
National Provider Identifier
1366716714
Registry record updated Sep 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
1-047-1990 Issued in GA
Legal business name
WYNFIELD PARK HEALTH AND REHABILITATION LLC
Doing business as
Wynfield Park Health and Rehabilitation
Practice address
223 W 3Rd Ave
Albany, GA 31701-2002
Phone
(229) 435-0741
Fax
(229) 435-9544
NPI assigned
Mar 2, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2023

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

Authorized official

Name
Kelly Burnett
Title
Administrator
Phone
(229) 435-0741

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 1-047-1990 GA Primary

Addresses

Primary practice location

223 W 3Rd Ave
Albany, GA 31701-2002

Mailing address

PO Box 2545
Albany, GA 31702-2545
Phone (229) 435-0741

Other identifiers 1

IdentifierTypeStateIssuer
000141512AMedicaidGA

Other names 1

  • Wynfield Park Health and Rehabilitation Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120919000351 GA Part A Provider - Skilled Nursing Facility 7719135631 Practice locations: Albany, GA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1366716714. Details of each certification follow.

Skilled nursing facility certification: CCN 115625

Legal name
WYNFIELD PARK HEALTH AND REHABILITATION, LLC
Doing business as
WYNFIELD PARK HEALTH AND REHABILITATION
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Jan 1, 1997
Last certification
Aug 10, 2023
Beds
186
Ownership / control type
Other Nonprofit
Multi-facility organization
Health Scholarships Inc
Organization structure
LLCNon-profit
Incorporated
Nov 3, 2011 in GA
Enrollment address
223 W 3Rd Ave
Albany, GA 31701-2002
Nursing home name
WYNFIELD PARK HEALTH AND REHABILITATION
Affiliated entity
ETHICA HEALTH

Care Compare: Nursing home

Medicare Care Compare
Listed as
Wynfield Park Health and RehabilitationCCN 115625 · All quality measures
Overall star rating
2 of 5
Health inspections
3 of 5
Staffing
3 of 5
Quality measures
1 of 5
Type
Medicare and Medicaid
Ownership
Non profit - Other
Certified
Jan 1, 1997
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
186167.6 residents per day on average
Chain
Ethica Health50 facilities in the chain

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
11D0675726Wynfield Park Health and Rehabilitation223 Third Ave, Albany, GA 31701Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory
Tax ID family
Albany Health Care Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 20

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

NameRoleSinceShare
Paul a Cable Individual Managing Control - Governing BodyBoard Member Mar 14, 2003
Organization, Gray, GA LLC, Medical provider/supplier, Non-profit Adp of the SNF Jul 7, 2025
Ralph Parks Warnock Individual Managing Control - Governing BodyBoard Member Jun 23, 2020
Kelly M Burnett Individual Operational/Managerial Control Nov 16, 2022
Adp of the SNF Jul 7, 2025
Ronnie D Rollins Individual Managing Control - Governing BodyBoard Member Mar 14, 2003
Organization, Albany, GA Adp of the SNF Jan 1, 2012
Michael D Satchell Individual Operational/Managerial Control Apr 1, 2021
Adp of the SNF Apr 1, 2021
Stacey Hill Individual Operational/Managerial Control Jan 1, 2026
Managing Control - Governing BodyVice President of Operations Jan 1, 2026
Sharon Stocking Individual Operational/Managerial Control Mar 6, 2024
Kathryn Dennis Individual Managing Control - Governing BodyBoard Member Nov 17, 2015
Clinical Services Inc Organization, Gray, GA Corporation, Management services company, Non-profit, Chain home office Operational/Managerial Control Jan 1, 2012 100%
Adp of the SNF Jul 7, 2025
Community Health Systems Inc Organization, Macon, GA Corporation, Non-profit Indirect Ownership Interest Jan 1, 2012 100%
Health Scholarships Inc Organization, Gray, GA Corporation, Holding company, Non-profit, Owned by another organization or individual Direct Ownership Interest Jan 1, 2012 100%
Organization, Gray, GA Corporation, Non-profit Adp of the SNF Jul 7, 2025
Individual Adp of the SNF Jan 1, 2024
Organization, Macon, GA LLC, Non-profit Adp of the SNF Jul 7, 2025
Individual Adp of the SNF Jan 1, 2025
Joseph a Wall Individual Managing Control - Governing BodyBoard Member Mar 14, 2003
Organization, Hawkinsville, GA Corporation, Medical provider/supplier, Non-profit Adp of the SNF Jul 7, 2025
Joseph Nichols Individual Managing Control - Governing BodyBoard Member Nov 19, 2024

Owners & managing parties with NPI records 2

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 49

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

View all 49

Practitioners & affiliated clinicians

Practitioners 1

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 2

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": "1330646400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1695859200000",
    "number": "1366716714",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2545",
            "city": "ALBANY",
            "state": "GA",
            "postal_code": "317022545",
            "telephone_number": "229-435-0741",
            "fax_number": "229-435-9544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "223 W 3RD AVE",
            "city": "ALBANY",
            "state": "GA",
            "postal_code": "317012002",
            "telephone_number": "229-435-0741",
            "fax_number": "229-435-9544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WYNFIELD PARK HEALTH AND REHABILITATION LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-02",
        "last_updated": "2023-09-28",
        "certification_date": "2023-09-28",
        "status": "A",
        "authorized_official_last_name": "BURNETT",
        "authorized_official_first_name": "KELLY",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "229-435-0741"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "GA",
            "license": "1-047-1990",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000141512A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wynfield Park Health and Rehabilitation",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Wynfield Park Health and Rehabilitation",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Albany, GA

Sources for this page

Verify at the official NPI Registry.