Organization Active NPI

Pruitthealth - Shepherd Hills, LLC

Doing business as PruittHealth - Shepherd Hills

  • Skilled Nursing Facility
  • La Fayette, GA
National Provider Identifier
1619922986
Registry record updated Jul 24, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
1-146-1671 Issued in GA
Legal business name
PRUITTHEALTH - SHEPHERD HILLS, LLC
Doing business as
PruittHealth - Shepherd Hills
Practice address
800 Patterson Rd
La Fayette, GA 30728-3330
Phone
(706) 638-4112
NPI assigned
May 24, 2006
Last updated
Jul 24, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2014

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

Authorized official

Name
Mr. Neil L. Pruitt Jr.
Title
Chairman & Ceo of MGR
Phone
(770) 279-6200

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 1-146-1671 GA Primary

Addresses

Primary practice location

800 Patterson Rd
La Fayette, GA 30728-3330

Mailing address

1626 Jeurgens CT
Norcross, GA 30093-2219
Phone (770) 279-6200

Other identifiers 1

IdentifierTypeStateIssuer
00142964AMedicaidGA

Other names 1

  • PruittHealth - Shepherd Hills Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060725000234 GA Part A Provider - Skilled Nursing Facility 4082627773 Practice locations: La Fayette, GA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1619922986. Details of each certification follow.

Skilled nursing facility certification: CCN 115452

Legal name
PRUITTHEALTH - SHEPHERD HILLS, LLC
Doing business as
PRUITTHEALTH - SHEPHERD HILLS
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Oct 1, 1989
Last certification
Jul 11, 2024
Beds
112
Ownership / control type
Corporation
Multi-facility organization
PRUITTHEALTH
Organization structure
LLCProprietary
Incorporated
Sep 27, 2007 in GA
Enrollment address
800 Patterson Rd
La Fayette, GA 30728-3330
Nursing home name
PRUITTHEALTH - SHEPHERD HILLS
Affiliated entity
PRUITTHEALTH

Care Compare: Nursing home

Medicare Care Compare
Listed as
Pruitthealth - Shepherd HillsCCN 115452 · All quality measures
Overall star rating
3 of 5
Health inspections
3 of 5
Staffing
2 of 5
Quality measures
2 of 5
Type
Medicare and Medicaid
Ownership
For profit - Corporation
Certified
Oct 1, 1989
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
112101.9 residents per day on average
Chain
Pruitthealth95 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
11D0992405Pruitthealth-Shepherd Hills, LLC800 Patterson Road, Lafayette, GA 30728Certificate of waiverOct 15, 2027

National Provider Directory

National Provider Directory

Locations

800 Patterson Rd
La Fayette, GA 30728
Phone (706) 638-4112

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, For-profit 5% Or Greater Indirect Ownership Interest Sep 27, 2007 100%
Pruitthealth Inc Organization, Toccoa, GA Corporation, For-profit Other Sep 27, 2007
Andy H Miller Individual W-2 Managing EmployeeFacility Administrator Aug 12, 2019 100%
Lisa P Hamby Trust Organization, Norcross, GA 5% Or Greater Indirect Ownership Interest Sep 27, 2007 26.13%
Neil Little Pruitt Individual Corporate OfficerChairman and Ceo Sep 27, 2007 100%
Corporate DirectorChairman and Ceo Sep 27, 2007 100%
OtherChain Home Office Administrator Sep 27, 2007 100%
Neil L Pruitt Jr Trust Organization, Norcross, GA 5% Or Greater Indirect Ownership Interest Sep 27, 2007 35.2%
Uhs-Pruitt Holdings, Inc. Organization, Norcross, GA Corporation, For-profit 5% Or Greater Indirect Ownership Interest Sep 27, 2007 100%
United Health Services of Georgia, Inc. Organization, Norcross, GA For-profit 5% Or Greater Direct Ownership Interest Sep 27, 2007 99%
J Paige Pruitt Trust Organization, Norcross, GA 5% Or Greater Indirect Ownership Interest Sep 27, 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 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.

NPI Registry JSON

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

{
    "created_epoch": "1148428800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1406160000000",
    "number": "1619922986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1626 JEURGENS CT",
            "city": "NORCROSS",
            "state": "GA",
            "postal_code": "300932219",
            "telephone_number": "770-279-6200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 PATTERSON RD",
            "city": "LA FAYETTE",
            "state": "GA",
            "postal_code": "307283330",
            "telephone_number": "706-638-4112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRUITTHEALTH - SHEPHERD HILLS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-24",
        "last_updated": "2014-07-24",
        "status": "A",
        "authorized_official_last_name": "PRUITT",
        "authorized_official_first_name": "NEIL",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "CHAIRMAN & CEO OF MGR",
        "authorized_official_telephone_number": "770-279-6200",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "GA",
            "license": "1-146-1671",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00142964A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PruittHealth - Shepherd Hills",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in La Fayette, GA

Sources for this page

Verify at the official NPI Registry.