NPIMap

Organization Active NPI

Wellstar MCG Health Warm Springs, Inc.

Doing business as Wellstar Long Term Acute Care at Warm Springs

  • Long Term Care Hospital
  • Warm Springs, GA
National Provider Identifier
1427468362
Registry record updated May 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care HospitalTaxonomy code 282E00000X
License
099-685 Issued in GA
Legal business name
WELLSTAR MCG HEALTH WARM SPRINGS, INC.
Doing business as
Wellstar Long Term Acute Care at Warm Springs
Wellstar Roosevelt Long Term Care at Warm Springs
Practice address
6135 Roosevelt Hwy
Warm Springs, GA 31830-2757
Phone
(706) 655-5337
Fax
(706) 655-5011
NPI assigned
Apr 30, 2014
Last updated
May 28, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 28, 2026

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

Authorized official

Name
Ebenezer Erzuah
Title
Exec Dir of Reimbursement
Phone
(470) 956-4981

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Long Term Care Hospital 282E00000X 099-685 GA Primary

Addresses

Primary practice location

6135 Roosevelt Hwy
Warm Springs, GA 31830-2757

Mailing address

6135 Roosevelt Hwy
PO Box 280
Warm Springs, GA 31830-2757
Phone (706) 655-5461

Other names 2

  • Wellstar Long Term Acute Care at Warm Springs Doing business as
  • Wellstar Roosevelt Long Term Care at Warm Springs Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20140909001298 GA Part A Provider - Hospital 8820217706 Practice locations: Warm Springs, GA
O20150708001997 GA Part B Supplier - Clinic/Group Practice 8820217706 Receives reassigned benefits from 34 practitioners
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Warm Springs, GA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1427468362. Details of each certification follow.

Hospital certification: CCN 112000

Legal name
ROOSEVELT WARM SPRINGS REHABILITATION & SPECIALTY HOSPITALS INC
Doing business as
ROOSEVELT WARM SPRINGS LTAC HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Long-term
Participating since
Jul 1, 1974
Last certification
Jul 27, 2023
Beds
32
Ownership / control type
State
Most recent change of ownership
Jul 1, 2012 (1 total)
Organization structure
CorporationNon-profit
Incorporated
Jul 1, 2014 in GA
Enrollment address
6135 Roosevelt Hwy
Warm Springs, GA 31830-2757
Other Hospital Practice Location
Hospital subgroups
Long-term

Other NPIs with the same Medicare PAC ID 1

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

Other NPIs on the same Medicare enrollment 2

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

Care Compare: Long-term care hospital

Medicare Care Compare
Listed as
Wellstar Roosevelt Long Term Acute Care at Warm SPCCN 112000 · All quality measures
Ownership
Government
Certified
Jul 1, 1974
Medicare certification status
ActiveFrom the Provider of Services file
Beds
32

National Provider Directory

National Provider Directory
Tax ID family
Wellstar MCG Health Warm Springs Inc4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Ownership & related parties

All disclosed owners & managing parties 22

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

NameRoleSinceShare
William C Brock Individual Corporate Director Aug 29, 2023
Au Health System Inc Organization, Augusta, GA Corporation, Non-profit 5% Or Greater Indirect Ownership Interest Aug 29, 2023 100%
Orrin S Swayze Individual Corporate Director Aug 29, 2023
John C McKibben Individual Corporate DirectorBoard Member Aug 29, 2023
Hiram Speer Burdette Individual Corporate Director Aug 29, 2023
Keith Parker Individual Corporate DirectorBoard Member Aug 29, 2023
Paul Lawrence Douglass Individual Corporate DirectorBoard Member Aug 29, 2023
Mitzi Moore Individual Corporate DirectorBoard Member Aug 29, 2023
Wellstar Health System Inc Organization, Marietta, GA Corporation, Non-profit 5% Or Greater Indirect Ownership Interest Aug 29, 2023 100%
James Glen Cunningham Individual Corporate DirectorBoard Member Aug 29, 2023
Anthony Budzinski Individual Corporate OfficerExecutive Vice President Aug 29, 2023
W-2 Managing EmployeeExecutive Vice President Aug 29, 2023
Ebenezer Erzuah Individual W-2 Managing EmployeeExecutive Director Government Aug 29, 2023
Mark Berry Individual Corporate DirectorBoard Member Aug 29, 2023
James Holmes Individual Corporate DirectorBoard Member Aug 29, 2023
Candice Saunders Individual Corporate Officer Aug 29, 2023
W-2 Managing EmployeePresident & Chief Executive O Aug 29, 2023 100%
James Swartz Individual W-2 Managing EmployeeVice President Accounting Aug 29, 2023
Greg Morgan Individual Corporate Director Aug 29, 2023
James L Hornsby Individual Corporate DirectorBoard Member Aug 29, 2023
Edward Richardson Individual Corporate DirectorBoard Member Aug 29, 2023
Arif Abdul Aziz Individual Corporate DirectorBoard Member Aug 29, 2023
David Bottoms Individual Corporate DirectorBoard Member Aug 29, 2023
Frank Ros Individual Corporate DirectorBoard Member Aug 29, 2023

Owners & managing parties with NPI records 4

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

Facilities with the same owner 18

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

View all 18

Practitioners & affiliated clinicians

Practitioners 6

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": "1398816000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1779926400000",
    "number": "1427468362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6135 ROOSEVELT HWY",
            "address_2": "PO BOX 280",
            "city": "WARM SPRINGS",
            "state": "GA",
            "postal_code": "318302757",
            "telephone_number": "706-655-5461",
            "fax_number": "706-655-5011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6135 ROOSEVELT HWY",
            "city": "WARM SPRINGS",
            "state": "GA",
            "postal_code": "318302757",
            "telephone_number": "706-655-5337",
            "fax_number": "706-655-5011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELLSTAR MCG HEALTH WARM SPRINGS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-04-30",
        "last_updated": "2026-05-28",
        "certification_date": "2026-05-28",
        "status": "A",
        "authorized_official_last_name": "ERZUAH",
        "authorized_official_first_name": "EBENEZER",
        "authorized_official_title_or_position": "EXEC DIR OF REIMBURSEMENT",
        "authorized_official_telephone_number": "470-956-4981"
    },
    "taxonomies": [
        {
            "code": "282E00000X",
            "taxonomy_group": "",
            "desc": "Long Term Care Hospital",
            "state": "GA",
            "license": "099-685",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wellstar Long Term Acute Care at Warm Springs",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Wellstar Roosevelt Long Term Care at Warm Springs",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Warm Springs, GA

Sources for this page

Verify at the official NPI Registry.