NPIMap

Organization Active NPI

Pruitthealth - Blue Ridge, LLC

Doing business as PruittHealth - Blue Ridge

  • Skilled Nursing Facility
  • Blue Ridge, GA
National Provider Identifier
1730136599
Registry record updated Apr 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
1-055-1198 Issued in GA
Legal business name
PRUITTHEALTH - BLUE RIDGE, LLC
Doing business as
PruittHealth - Blue Ridge
Practice address
99 Ouida St
Blue Ridge, GA 30513-4627
Phone
(706) 632-2271
Fax
(706) 632-7633
NPI assigned
May 27, 2006
Last updated
Apr 7, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2021

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

Authorized official

Name
Mr. Neil L Pruitt
Title
Chairman and Ceo
Phone
(770) 279-6200

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 1-055-1198 GA Primary

Addresses

Primary practice location

99 Ouida St
Blue Ridge, GA 30513-4627

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
00140973AMedicaidGA

Other names 1

  • PruittHealth - Blue Ridge Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20051205000362 GA Part A Provider - Skilled Nursing Facility 2860412954 1 other NPI on this enrollment
Practice locations: Blue Ridge, GA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1730136599. Details of each certification follow.

Skilled nursing facility certification: CCN 115468

Legal name
PRUITTHEALTH - BLUE RIDGE, LLC
Doing business as
PRUITTHEALTH - BLUE RIDGE
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Jul 5, 1989
Last certification
Mar 7, 2024
Beds
101
Ownership / control type
Corporation
Multi-facility organization
Pruitthealth
Organization structure
LLCProprietary
Enrollment address
99 Ouida St
Blue Ridge, GA 30513-4627
Nursing home name
PRUITTHEALTH - BLUE RIDGE
Affiliated entity
PRUITTHEALTH

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Care Compare: Nursing home

Medicare Care Compare
Listed as
Pruitthealth - Blue RidgeCCN 115468 · All quality measures
Overall star rating
5 of 5
Health inspections
4 of 5
Staffing
3 of 5
Quality measures
5 of 5
Type
Medicare and Medicaid
Ownership
For profit - Corporation
Certified
Jul 5, 1989
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
10184.5 residents per day on average
Chain
Pruitthealth95 facilities in the chain

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory
Tax ID family
Blue Ridge Health Care Center Inc2 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 18

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

NameRoleSinceShare
Individual Adp of the SNF Nov 27, 2013
NWP 2020 Child TR Fbo Lisa P Hamby Organization, Norcross, GA Indirect Ownership Interest Aug 12, 2020 2.4%
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 Sep 19, 2007 100%
Philip W. Small Individual Managing Control - Governing BodyDirector Nov 27, 2013
Lisa P Hamby Trust Organization, Norcross, GA Adp of the SNF Jun 22, 2021
Indirect Ownership Interest Jun 22, 2021 21.44%
Neil Little Pruitt Individual Corporate OfficerChairman and Ceo Oct 20, 2005 100%
Operational/Managerial Control Nov 27, 2013
Indirect Ownership Interest Nov 27, 2013 1%
Neil L Pruitt Jr Trust Organization, Norcross, GA 5% Or Greater Indirect Ownership Interest Sep 19, 2007 42.86%
Adp of the SNF Aug 12, 2020
Indirect Ownership Interest Aug 12, 2020 42.86%
NWP 2020 Child TR Fbo Neil L Pruitt Jr Organization, Norcross, GA Indirect Ownership Interest Aug 12, 2020 2.4%
Amar Mohan Individual Operational/Managerial Control Jul 17, 2020
Adp of the SNF Mar 6, 2026
Pruitt Family Trust Organization, Norcross, GA Adp of the SNF Aug 12, 2020
Indirect Ownership Interest Aug 18, 2020 1.59%
Natasha J. Negron Individual Operational/Managerial Control Sep 13, 2024
Adp of the SNF Mar 25, 2025
Organization, Norcross, GA Corporation Adp of the SNF Jan 7, 2019
Indirect Ownership Interest Jan 7, 2019
Pruitthealth Consulting Services Inc Organization, Norcross, GA Corporation Adp of the SNF Nov 26, 2013
Individual Adp of the SNF Nov 27, 2013
Uhs-Pruitt Holdings, Inc. Organization, Norcross, GA Holding company Indirect Ownership Interest Nov 27, 2013
United Health Services of Georgia, Inc. Organization, Norcross, GA Corporation, Holding company, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Sep 19, 2007 99%
Direct Ownership Interest Nov 27, 2013 99%
Individual Adp of the SNF Nov 11, 2019
J Paige Pruitt Trust Organization, Norcross, GA Indirect Ownership Interest Nov 27, 2013 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.

Facilities with the same owner 120

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

View all 120

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.

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": "1148688000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1617753600000",
    "number": "1730136599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1626 JEURGENS CT",
            "address_2": "LEGAL DEPT",
            "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": "99 OUIDA ST",
            "city": "BLUE RIDGE",
            "state": "GA",
            "postal_code": "305134627",
            "telephone_number": "706-632-2271",
            "fax_number": "706-632-7633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRUITTHEALTH - BLUE RIDGE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-27",
        "last_updated": "2021-04-07",
        "certification_date": "2021-03-17",
        "status": "A",
        "authorized_official_last_name": "PRUITT",
        "authorized_official_first_name": "NEIL",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CHAIRMAN AND CEO",
        "authorized_official_telephone_number": "770-279-6200",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "GA",
            "license": "1-055-1198",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00140973A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PruittHealth - Blue Ridge",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "PruittHealth - Blue Ridge",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Blue Ridge, GA

Sources for this page

Verify at the official NPI Registry.