NPIMap

Organization Active NPI

Magnolia Manor, Inc.

  • Skilled Nursing Facility
  • Americus, GA
National Provider Identifier
1588647754
Registry record updated Mar 3, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
1129065 Issued in GA
Legal business name
MAGNOLIA MANOR, INC.
Practice address
2001 S Lee St
Americus, GA 31709-4715
Phone
(229) 924-9352
Fax
(229) 931-5999
NPI assigned
Nov 22, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2010

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

Authorized official

Name
Mr. Hill Fort
Title
Administrator
Phone
(229) 931-5942

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 1129065 GA Primary

Addresses

Primary practice location

2001 S Lee St
Americus, GA 31709-4715

Mailing address

2001 S Lee St
Americus, GA 31709-4715
Phone (229) 924-9352

Other identifiers 1

IdentifierTypeStateIssuer
00040785AMedicaidGA

Other names 1

  • Magnolia Manor Nursing Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100302000708 GA Part A Provider - Skilled Nursing Facility 9638139751 Practice locations: Americus, GA

Skilled nursing facility certification: CCN 115004

Legal name
MAGNOLIA MANOR INC
Doing business as
MAGNOLIA MANOR NURSING CENTER
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Jan 1, 1967
Last certification
Mar 14, 2025
Beds
238
Ownership / control type
Nonprofit Corporation
Multi-facility organization
Magnolia Manor Inc.
Organization structure
CorporationNon-profit
Incorporated
Nov 30, 1962 in GA
Enrollment address
2001 South Lee Street
Americus, GA 31709-4715
Nursing home name
MAGNOLIA MANOR METHODIST NSG C
Affiliated entity
MAGNOLIA MANOR SENIOR LIVING

Care Compare: Nursing home

Medicare Care Compare
Listed as
Magnolia Manor Methodist NSG CCCN 115004
Overall star rating
3 of 5
Health inspections
3 of 5
Staffing
2 of 5
Quality measures
3 of 5
Type
Medicare and Medicaid
Ownership
Non profit - Corporation
Certified
Jan 1, 1967
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
238166.2 residents per day on average
Chain
Magnolia Manor Senior Living5 facilities in the chain

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory
Tax ID family
Magnolia Manor Pharmacy2 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 5

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

NameRoleSinceShare
Mark R Todd Individual Corporate DirectorChief Executive Officer Jan 11, 2010
Angela High Individual W-2 Managing EmployeeAdministrator Apr 25, 2021
Brad Fussell Individual Operational/Managerial ControlDirector of Finance Oct 1, 2016
Susie Fussell Individual Operational/Managerial ControlAdministrator Jul 31, 2011
Hillery V Fort Individual W-2 Managing EmployeeChief Operations Officer Aug 30, 2004

All facility ownership & control disclosures 4

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Magnolia Manor of Marion CountyBuena Vista, GA, CCN 115599 Skilled nursing facility Operational/Managerial Control Jul 1, 2004
Magnolia Manor of Columbus Nursing Center EastColumbus, GA, CCN 115124 Skilled nursing facility Operational/Managerial Control Jan 1, 2007
Magnolia Manor of Columbus IncColumbus, GA, CCN 115045 Skilled nursing facility Operational/Managerial Control Jan 1, 2007
Magnolia Manor of MidwayMidway, GA, CCN 115553 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Sep 10, 2019

Owned or controlled facilities with NPI records 4

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

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": "1132617600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1267574400000",
    "number": "1588647754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 S LEE ST",
            "city": "AMERICUS",
            "state": "GA",
            "postal_code": "317094715",
            "telephone_number": "229-924-9352",
            "fax_number": "229-931-5999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 S LEE ST",
            "city": "AMERICUS",
            "state": "GA",
            "postal_code": "317094715",
            "telephone_number": "229-924-9352",
            "fax_number": "229-931-5999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAGNOLIA MANOR, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-22",
        "last_updated": "2010-03-03",
        "status": "A",
        "authorized_official_last_name": "FORT",
        "authorized_official_first_name": "HILL",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "229-931-5942",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "GA",
            "license": "1129065",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00040785A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Magnolia Manor Nursing Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Americus, GA

Sources for this page

Verify at the official NPI Registry.