NPIMap

Organization Active NPI

Pruitthealth - Fleming Island, LLC

  • Skilled Nursing Facility
  • Fleming Island, FL
National Provider Identifier
1649758012
Registry record updated Nov 9, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
PRUITTHEALTH - FLEMING ISLAND, LLC
Practice address
2040 Town Center Boulevard
Fleming Island, FL 32003
Phone
(904) 293-1311
NPI assigned
Jul 30, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2018

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 & Ceo of Manager'S Manager
Phone
(770) 279-6200

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

2040 Town Center Boulevard
Fleming Island, FL 32003

Mailing address

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

Other names 1

  • PruittHealth - Fleming Island Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190201001521 FL Part A Provider - Skilled Nursing Facility 7214274018 Practice locations: Fleming Island, FL

Skilled nursing facility certification: CCN 106124

Legal name
PRUITTHEALTH - FLEMING ISLAND, LLC
Doing business as
PRUITTHEALTH - FLEMING ISLAND
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
May 9, 2019
Last certification
Oct 8, 2024
Beds
97
Ownership / control type
Limited Liability Corporation
Multi-facility organization
Pruitthealth
Organization structure
LLCProprietary
Incorporated
Oct 16, 2014 in FL
Enrollment address
2040 Town Center Blvd
Fleming Island, FL 32003-6321
Nursing home name
PRUITTHEALTH - FLEMING ISLAND
Affiliated entity
PRUITTHEALTH

Care Compare: Nursing home

Medicare Care Compare
Listed as
Pruitthealth - Fleming IslandCCN 106124
Overall star rating
2 of 5
Health inspections
2 of 5
Staffing
4 of 5
Quality measures
4 of 5
Type
Medicare and Medicaid
Ownership
For profit - Limited Liability company
Certified
May 9, 2019
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
9791.0 residents per day on average
Chain
Pruitthealth95 facilities in the chain
Penalties (3 years)
3Fines totaling $16,153

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
10D2159858Pruitthealth - Fleming Island, LLC2040 Town Center Blvd, Fleming Island, FL 32003Certificate of waiverDec 27, 2026

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 21

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

NameRoleSinceShare
Organization, Norcross, GA Adp of the SNF Aug 18, 2020
Indirect Ownership Interest Aug 18, 2020 1.59%
United Health Services Inc Organization, Norcross, GA Created for acquisition, Corporation, Holding company, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Oct 16, 2014 99%
Indirect Ownership Interest Nov 27, 2013 99%
Robert Strang Individual Adp of the SNF Aug 15, 2011
Philip W. Small Individual Corporate DirectorDirector Nov 27, 2013
United Health Services of Florida, Inc Organization, Norcross, GA Corporation, Holding company 5% Or Greater Direct Ownership Interest Oct 16, 2014 99%
Direct Ownership Interest Oct 16, 2014 99%
Lisa P Hamby Trust Organization, Norcross, GA 5% Or Greater Indirect Ownership Interest Jun 22, 2021 22.98%
Adp of the SNF Jun 22, 2021
Indirect Ownership Interest Jun 22, 2021 22.98%
Neil Little Pruitt Individual Corporate OfficerChairman and Ceo Oct 16, 2014
Direct Ownership Interest Nov 27, 2013 1%
Clay Healthcare Properties, Inc Organization, Norcross, GA Corporation, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Apr 20, 2017 100%
Adp of the SNF Oct 5, 2018
Neil L Pruitt Jr Trust Organization, Norcross, GA 5% Or Greater Indirect Ownership Interest Jun 22, 2021 42.86%
Adp of the SNF Jun 22, 2021
Indirect Ownership Interest Jun 22, 2021 42.86%
NWP 2020 Child TR Fbo Neil L Pruitt Jr Organization, Norcross, GA 5% Or Greater Indirect Ownership Interest Aug 12, 2020 6.29%
Indirect Ownership Interest Aug 12, 2020 2.4%
NWP 2020 Child TR Fbo J Paige Pruitt Organization, Norcross, GA Indirect Ownership Interest Aug 12, 2020 2.4%
Nancy W Pruitt Individual Corporate OfficerSecretary/Director Nov 27, 2013
Individual Adp of the SNF Nov 11, 2019
Pruitthealth Consulting Services Inc Organization, Norcross, GA Corporation Adp of the SNF Nov 26, 2013
Connie Odonnell Individual Operational/Managerial Control Mar 20, 2023
Adp of the SNF Apr 3, 2025
Uhs-Pruitt Holdings, Inc. Organization, Norcross, GA Corporation, Holding company 5% Or Greater Indirect Ownership Interest Oct 16, 2014 99%
Individual Adp of the SNF Nov 27, 2013
Pruitthealth-Northeast Florida, LLC Organization, Norcross, GA LLC Indirect Ownership Interest Oct 16, 2014 99%
Organization, Norcross, GA Indirect Ownership Interest Aug 12, 2020 2.4%
David Samara Individual Operational/Managerial Control Oct 1, 2018
Adp of the SNF Jan 7, 2026
J Paige Pruitt Trust Organization, Norcross, GA 5% Or Greater Indirect Ownership Interest Jun 22, 2021 21.44%
Adp of the SNF Jun 22, 2021
Indirect Ownership Interest Jun 22, 2021 21.44%

Owners & managing parties with NPI records 1

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

  • David J Samara, MD
    • Geriatric Medicine (Family Medicine) Physician
    • Jacksonville, FL
    • NPI 1679513477

    Adp of the SNF, Operational/Managerial Control

    CMS ownership

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

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": "1532908800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1541721600000",
    "number": "1649758012",
    "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": "2040 TOWN CENTER BOULEVARD",
            "city": "FLEMING ISLAND",
            "state": "FL",
            "postal_code": "32003",
            "telephone_number": "904-293-1311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRUITTHEALTH - FLEMING ISLAND, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-30",
        "last_updated": "2018-11-09",
        "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 MANAGER'S MANAGER",
        "authorized_official_telephone_number": "770-279-6200",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PruittHealth - Fleming Island",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "PruittHealth - Fleming Island",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fleming Island, FL

Sources for this page

Verify at the official NPI Registry.