Organization Active NPI

Pruitthealth - Old Capitol, LLC

Doing business as PruittHealth - Old Capitol

  • Skilled Nursing Facility
  • Louisville, GA
National Provider Identifier
1467409987
Registry record updated Apr 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
1-081-1569 Issued in GA
Legal business name
PRUITTHEALTH - OLD CAPITOL, LLC
Doing business as
PruittHealth - Old Capitol
Practice address
310 Highway 1 Bypass
Louisville, GA 30434-6432
Phone
(478) 625-3741
Fax
(478) 625-9473
NPI assigned
May 29, 2006
Last updated
Apr 7, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2021

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

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 1-081-1569 GA Primary

Addresses

Primary practice location

310 Highway 1 Bypass
Louisville, GA 30434-6432

Mailing address

1626 Jeurgens CT
Legal Dept
Norcross, GA 30093-2219
Phone (678) 533-6485

Other identifiers 1

IdentifierTypeStateIssuer
00142304AMedicaidGA

Other names 1

  • PruittHealth - Old Capitol Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050428000104 GA Part A Provider - Skilled Nursing Facility 4284673377 Practice locations: Louisville, GA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1467409987. Details of each certification follow.

Skilled nursing facility certification: CCN 115681

Legal name
PRUITTHEALTH - OLD CAPITOL, LLC
Doing business as
PRUITTHEALTH - OLD CAPITOL
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Jan 30, 2003
Last certification
May 23, 2024
Beds
143
Ownership / control type
Limited Liability Corporation
Organization structure
LLCProprietary
Incorporated
Sep 25, 2007 in GA
Enrollment address
310 US Highway 1 Byp S
Louisville, GA 30434-6432
Nursing home name
PRUITTHEALTH - OLD CAPITOL
Affiliated entity
PRUITTHEALTH

Care Compare: Nursing home

Medicare Care Compare
Listed as
Pruitthealth - Old CapitolCCN 115681 · All quality measures
Overall star rating
1 of 5
Health inspections
1 of 5
Staffing
2 of 5
Quality measures
4 of 5
Type
Medicare and Medicaid
Ownership
For profit - Limited Liability company
Certified
Jan 30, 2003
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
143100.9 residents per day on average
Chain
Pruitthealth95 facilities in the chain
Penalties (3 years)
4Fines totaling $28,179

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
11D0645917Pruitthealth - Old Capitol310 Highway #1 Bypass, Louisville, GA 30434Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 9

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

NameRoleSinceShare
United Health Services Inc Organization, Norcross, GA Corporation, Holding company, For-profit 5% Or Greater Indirect Ownership Interest Mar 27, 2008 100%
Pruitthealth Inc Organization, Norcross, GA Corporation, For-profit Other Sep 25, 2007
Lisa P Hamby Trust Organization, Norcross, GA 5% Or Greater Indirect Ownership Interest Sep 25, 2007 26.13%
Neil Little Pruitt Individual Corporate OfficerChairman and Ceo Sep 25, 2007 100%
Corporate DirectorChairman and Ceo Sep 25, 2007 100%
Operational/Managerial ControlCho Adminsitrator-Authorized Off Sep 25, 2007
OtherCho Administrator/Ao Sep 25, 2007 100%
Neil L Pruitt Jr Trust Organization, Norcross, GA 5% Or Greater Indirect Ownership Interest Sep 25, 2007 35.2%
Tracy Brown Individual W-2 Managing EmployeeFacility Administrator May 31, 2021 100%
Uhs-Pruitt Holdings, Inc. Organization, Norcross, GA Corporation, Holding company, For-profit 5% Or Greater Indirect Ownership Interest Mar 27, 2008 100%
United Health Services of Georgia, Inc. Organization, Norcross, GA Corporation, For-profit 5% Or Greater Direct Ownership Interest Mar 27, 2008 99%
J Paige Pruitt Trust Organization, Norcross, GA 5% Or Greater Indirect Ownership Interest Sep 25, 2007 28.84%

Facilities with the same owner 123

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

View all 123

Practitioners & affiliated clinicians

Practitioners 3

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 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": "1148860800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1617753600000",
    "number": "1467409987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1626 JEURGENS CT",
            "address_2": "LEGAL DEPT",
            "city": "NORCROSS",
            "state": "GA",
            "postal_code": "300932219",
            "telephone_number": "678-533-6485",
            "fax_number": "770-931-5278"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 HIGHWAY 1 BYPASS",
            "city": "LOUISVILLE",
            "state": "GA",
            "postal_code": "304346432",
            "telephone_number": "478-625-3741",
            "fax_number": "478-625-9473"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRUITTHEALTH - OLD CAPITOL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-29",
        "last_updated": "2021-04-07",
        "certification_date": "2021-03-17",
        "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": "1-081-1569",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00142304A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PruittHealth - Old Capitol",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "PruittHealth - Old Capitol",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Louisville, GA

Sources for this page

Verify at the official NPI Registry.