NPIMap

Organization Active NPI

Magnolia Manor of Marion County Inc

  • Skilled Nursing Facility
  • Buena Vista, GA
National Provider Identifier
1659353134
Registry record updated Apr 29, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
10961816 Issued in GA
Legal business name
MAGNOLIA MANOR OF MARION COUNTY INC
Practice address
349 Geneva Rd
Buena Vista, GA 31803-1701
Phone
(229) 649-2331
NPI assigned
Nov 18, 2005
Last updated
Apr 29, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2008

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

Authorized official

Name
Mrs. Barbara Mitchell
Title
Administrator
Phone
(229) 649-2331

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 10961816 GA Primary

Addresses

Primary practice location

349 Geneva Rd
Buena Vista, GA 31803-1701

Mailing address

349 Geneva Rd
Buena Vista, GA 31803-1701
Phone (229) 649-2331

Other identifiers 1

IdentifierTypeStateIssuer
00141809AMedicaidGA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041013000905 GA Part A Provider - Skilled Nursing Facility 9032179155 Practice locations: Buena Vista, GA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1659353134. Details of each certification follow.

Skilled nursing facility certification: CCN 115599

Legal name
MAGNOLIA MANOR OF MARION COUNTY INC
Doing business as
MAGNOLIA MANOR OF MARION COUNTY
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Jan 1, 1996
Last certification
Jan 16, 2025
Beds
70
Ownership / control type
Nonprofit Corporation
Multi-facility organization
Magnolia Manor
Organization structure
CorporationNon-profit
Incorporated
Jun 3, 2004 in GA
Enrollment address
349 Geneva Rd
Buena Vista, GA 31803-1701
Nursing home name
MAGNOLIA MANOR OF MARION COUNTY
Affiliated entity
MAGNOLIA MANOR SENIOR LIVING

Care Compare: Nursing home

Medicare Care Compare
Listed as
Magnolia Manor of Marion CountyCCN 115599 · All quality measures
Overall star rating
5 of 5
Health inspections
4 of 5
Staffing
4 of 5
Quality measures
5 of 5
Type
Medicare and Medicaid
Ownership
Non profit - Corporation
Certified
Jan 1, 1996
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
7063.8 residents per day on average
Chain
Magnolia Manor Senior Living5 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
11D0987112Magnolia Manor of Marion County Incorporate349 Geneva Road, Buena Vista, GA 31803Certificate of waiverMay 28, 2027

National Provider Directory

National Provider Directory

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 3

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

NameRoleSinceShare
Angela Watkins Individual Operational/Managerial ControlAdministrator Sep 9, 2012
Mark R Todd Individual Corporate Director Oct 13, 2004
Magnolia Manor Inc Organization, Americus, GA Operational/Managerial Control Jul 1, 2004

Owners & managing parties with NPI records 1

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

Facilities with the same owner 3

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

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.

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": "1132272000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1209427200000",
    "number": "1659353134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "349 GENEVA RD",
            "city": "BUENA VISTA",
            "state": "GA",
            "postal_code": "318031701",
            "telephone_number": "229-649-2331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "349 GENEVA RD",
            "city": "BUENA VISTA",
            "state": "GA",
            "postal_code": "318031701",
            "telephone_number": "229-649-2331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAGNOLIA MANOR OF MARION COUNTY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-18",
        "last_updated": "2008-04-29",
        "status": "A",
        "authorized_official_last_name": "MITCHELL",
        "authorized_official_first_name": "BARBARA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "229-649-2331",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "GA",
            "license": "10961816",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00141809A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Buena Vista, GA

Sources for this page

Verify at the official NPI Registry.