Active NPI
Donalsonville Hospital, Inc
Doing business as D/B/A Seminole Manor Nursing Home
- Skilled Nursing Facility
- Donalsonville, GA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- Legal business name
- DONALSONVILLE HOSPITAL, INC
- Doing business as
- D/B/A Seminole Manor Nursing Home
- Practice address
- 100 Hospital Cir
Donalsonville, GA 39845-1100 - Phone
- (229) 524-5217
- Fax
- (229) 524-6038
- NPI assigned
- Oct 10, 2005
- Last updated
- Feb 12, 2015
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Charles H. Orrick, NHA
- Title
- Administrator
- Phone
- (229) 524-5217
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | Primary |
Addresses
Primary practice location
100 Hospital Cir
Donalsonville, GA 39845-1100
Mailing address
102 Hospital Cir
Donalsonville, GA 39845-1100
Phone (229) 524-5217
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00142909 | Medicaid | GA | |
| 115712 | Other | GA | TPAN |
Other names 1
- D/B/A Seminole Manor Nursing Home
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20050421001077 | GA | Part A Provider - Skilled Nursing Facility | 7113919820 | Practice locations: Donalsonville, GA |
NPI to CCN mapping 1
The Medicare certification numbers (CCNs) connected to NPI 1710975206. Details of each certification follow.
Skilled nursing facility certification: CCN 115712
- Legal name
- DONALSONVILLE HOSPITAL INC
- Doing business as
- SEMINOLE MANOR NURSING HOME
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Dec 1, 2005
- Last certification
- Apr 25, 2025
- Beds
- 75
- Ownership / control type
- Nonprofit Corporation
- Multi-facility organization
- Donalsonville Hospital Inc
- Organization structure
- Corporation
- Incorporated
- Dec 15, 1977 in GA
- Enrollment address
- 100 Florence Ave
Donalsonville, GA 39845-1100 - Nursing home name
- SEMINOLE MANOR NURSING HOME
Other NPIs with the same Medicare PAC ID 2
NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).
Care Compare: Nursing home
Medicare Care Compare- Listed as
- Seminole Manor Nursing Home
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- Non profit - Corporation
- Certified
- Dec 1, 2005
- Medicare certification status
- Active
- Certified beds
- 75
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 11D2195797 | Seminole Manor Nursing Home | Certificate of waiver | Oct 12, 2026 |
National Provider Directory
National Provider Directory- Tax ID family
- Donalsonville Hospital Inc
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Rural Acute Care Hospital
- Donalsonville, GA
- NPI 1932645777
Member organizations 1
Organizations listed as members of this organization in the National Provider Directory.
Locations
100 Florence Ave
Donalsonville, GA 39845
Phone (229) 524-2733
100 Hospital Cir
Donalsonville, GA 39845
205 Bresee St
Donalsonville, GA 39845
Phone (229) 524-1307
Interoperability endpoints
- https://fhir-usa.unify.chbase.com/org/donalso-e0e81471
Ownership & related parties
All disclosed owners & managing parties 10
As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.
| Name | Role | Since | Share |
|---|---|---|---|
| Karen Livingston | Corporate Officer | Dec 1, 2025 | |
| Marian Hunter | Corporate Officer | Jan 1, 2023 | |
| Operational/Managerial Control | Jan 1, 2023 | ||
| Adp of the SNF | Jan 26, 2026 | ||
| Terry Shamblin | Managing Control - Governing Body | Jan 1, 2023 | |
| Adp of the SNF | Jan 26, 2026 | ||
| Virginia Whittaker | Managing Control - Governing Body | Jan 1, 2023 | |
| William Burke | Managing Control - Governing Body | Jan 1, 2023 | |
| William J Moody | Corporate Officer | Jan 1, 2023 | |
| Herman Brookins | Corporate Officer | Jan 1, 2023 | |
| Managing Control - Governing Body | Jan 1, 2023 | ||
| Mitchell Blanks | Managing Control - Governing Body | Jan 1, 2023 | |
| Charles H Orrick | Managing Control - Governing Body | Jan 1, 2023 |
All facility ownership & control disclosures 2
Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.
| Facility | Type | Role | Since |
|---|---|---|---|
| Donalsonville Hospital Inc | Hospital | 5% Or Greater Direct Ownership Interest (100%) Operational/Managerial Control (100%) |
Jul 1, 2017 Oct 1, 1991 |
| Donalsonville Hospital Swing Bed Unit | Hospital | Operational/Managerial Control (100%) | Oct 1, 1991 |
Owned or controlled facilities with NPI records 1
Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.
-
- Rural Acute Care Hospital
- Donalsonville, GA
- NPI 1720095805
5% Or Greater Direct Ownership Interest, Operational/Managerial Control
Practitioners & affiliated clinicians
Practitioners 4
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.
-
- Family Medicine Physician
- Donalsonville, GA
- NPI 1295815215
-
- Internal Medicine Physician
- Donalsonville, GA
- NPI 1609872217
-
- Family Medicine Physician
- Donalsonville, GA
- NPI 1912906918
-
- Surgery Physician
- Donalsonville, GA
- NPI 1396866943
Affiliated clinicians 6
Clinicians who list this facility as an affiliation in Medicare Care Compare.
-
- General Practice Physician
- Donalsonville, GA
- NPI 1962842013
Nursing home
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1128902400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1423699200000",
"number": "1710975206",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "102 HOSPITAL CIR",
"city": "DONALSONVILLE",
"state": "GA",
"postal_code": "398451100",
"telephone_number": "229-524-5217",
"fax_number": "229-524-6038"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 HOSPITAL CIR",
"city": "DONALSONVILLE",
"state": "GA",
"postal_code": "398451100",
"telephone_number": "229-524-5217",
"fax_number": "229-524-6038"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "DONALSONVILLE HOSPITAL, INC",
"organizational_subpart": "NO",
"enumeration_date": "2005-10-10",
"last_updated": "2015-02-12",
"status": "A",
"authorized_official_last_name": "ORRICK",
"authorized_official_first_name": "CHARLES",
"authorized_official_middle_name": "H.",
"authorized_official_title_or_position": "ADMINISTRATOR",
"authorized_official_telephone_number": "229-524-5217",
"authorized_official_name_prefix": "Mr.",
"authorized_official_credential": "NHA"
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00142909",
"state": "GA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TPAN",
"identifier": "115712",
"state": "GA"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "D/B/A Seminole Manor Nursing Home",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Donalsonville, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2015; 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.