Northeast Georgia Medical Center Habersham LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

NORTHEAST GEORGIA MEDICAL CENTER HABERSHAM LLC

Practice address

541 Historic Highway 441 N
Demorest, GA 30535

Phone

(706) 754-2161

NPI assigned

Mar 14, 2023

Organization subpart

No

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

Authorized official

Name

Mr. Brian D Steines

Title

Chief Financial Officer

Phone

(770) 219-1703

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1497456776. Details of each certification follow.

• CCN 115099 Skilled nursing facility · Active · Details

Skilled nursing facility certification: CCN 115099

Legal name

NORTHEAST GEORGIA MEDICAL CENTER HABERSHAM LLC

Doing business as

NEW HORIZONS HABERSHAM

Certification status

Active

Provider type (POS)

Nursing home – SNF/NF dual certification

Participating since

Mar 6, 1969

Last certification

Dec 12, 2024

Beds

84

Ownership / control type

Nonprofit Corporation

Multi-facility organization

Northeast Georgia Health System

Most recent change of ownership

Jul 1, 2023

Organization structure

LLCNon-profit

Incorporated

Jul 1, 2023 in GA

Enrollment address

105 Habersham Terrace GDNS
Demorest, GA 30535-4558

Nursing home name

NEW HORIZONS HABERSHAM

Other NPIs with the same Medicare PAC ID 1

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

• Northeast Georgia Medical Center Habersham LLC

  • General Acute Care Hospital
  • Demorest, GA
  • NPI 1740981430

  8224492897

  Same PAC ID

Listed as

New Horizons HabershamCCN 115099 · All quality measures

Overall star rating

4 of 5

Health inspections

4 of 5

Staffing

3 of 5

Quality measures

2 of 5

Type

Medicare and Medicaid

Ownership

Non profit - Corporation

Certified

Mar 6, 1969

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

8462.5 residents per day on average

Processed by Care Compare on Aug 1, 2026.

Tax ID family

Northeast Georgia Medical Center Habersham LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

• Northeast Georgia Medical Center Habersham LLC

  • General Acute Care Hospital
  • Demorest, GA
  • NPI 1740981430
  NPD tax ID
• Northeast Georgia Medical Habersham LLC

  • Community/Retail Pharmacy
  • Demorest, GA
  • NPI 1508644915
  NPD tax ID

All disclosed owners & managing parties 18

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

Owners & managing parties with NPI records 3

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

• Deepak K Aggarwal, M.D.

  • Nephrology Physician
  • Gainesville, GA
  • NPI 1962687483

  Corporate Director

  CMS ownership
• Mohak P Dave, M.D.

  • Emergency Medicine Physician
  • Gainesville, GA
  • NPI 1871538801

  Corporate Director

  CMS ownership
• Benjamin Lee Hawkins, DMD

  • General Practice Dentistry
  • Gainesville, GA
  • NPI 1710085618

  Corporate Director

  CMS ownership

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.

• Peaesha Lynette Houston, DO

  • Family Medicine Physician
  • Buford, GA
  • NPI 1285054742
  NPD (past)

Affiliated clinicians 1

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

• Peaesha Lynette Houston, DO

  • Family Medicine Physician
  • Buford, GA
  • NPI 1285054742

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1678752000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678752000000",
    "number": "1497456776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 741891",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303741891"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "541 HISTORIC HIGHWAY 441 N",
            "city": "DEMOREST",
            "state": "GA",
            "postal_code": "30535",
            "telephone_number": "706-754-2161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHEAST GEORGIA MEDICAL CENTER HABERSHAM LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-14",
        "last_updated": "2023-03-14",
        "certification_date": "2023-03-10",
        "status": "A",
        "authorized_official_last_name": "STEINES",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "770-219-1703",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nancy M Watson MD PC
• Wyatt V Nicholson
• Joe Dillard Noggle Jr., M.D.
• North Georgia Physical Therapy, LLC (NGPT)
• Northeast Georgia Home Health III LLC
• Northeast Georgia Medical Center Habersham LLC
• Northeast Georgia Medical Center Habersham LLC
• Northeast Georgia Medical Habersham LLC
• Northside Imaging LLC
• Northwest Diagnostic Imaging, Inc (MRI & Imaging of Habersham, LLC)

• Skilled Nursing Facility in Demorest, GA
• Providers in Demorest, 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 Mar 14, 2023; 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.