NPIMap

Organization Active NPI

Golden Age Oak View Home LLC

Doing business as Oak View

  • Skilled Nursing Facility
  • Waverly Hall, GA
National Provider Identifier
1740222801
Registry record updated Sep 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
1-072-1703 Issued in GA
Legal business name
GOLDEN AGE OAK VIEW HOME LLC
Doing business as
Oak View
Practice address
119 Oak View St
Waverly Hall, GA 31831-0459
Phone
(706) 582-2117
Fax
(706) 582-2116
NPI assigned
Jun 12, 2006
Last updated
Sep 28, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2023

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

Authorized official

Name
Kayla JeffersonNPI 1801208996
Title
Administrator
Phone
(706) 582-2117

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 1-072-1703 GA Primary

Addresses

Primary practice location

119 Oak View St
Waverly Hall, GA 31831-0459

Mailing address

PO Box 459
Waverly Hall, GA 31831-0459
Phone (706) 582-2117

Other identifiers 2

IdentifierTypeStateIssuer
51003285 001OtherBCBS
00142249AMedicaidGA

Other names 1

  • Oak View Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040122000261 GA Part A Provider - Skilled Nursing Facility 9638071558 Practice locations: Waverly Hall, GA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1740222801. Details of each certification follow.

Skilled nursing facility certification: CCN 115576

Legal name
GOLDEN AGE OAK VIEW HOME LLC
Doing business as
OAK VIEW
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Nov 1, 1994
Last certification
May 10, 2024
Beds
100
Ownership / control type
Other Nonprofit
Multi-facility organization
Health Systems Facilities, Inc.
Organization structure
LLCNon-profit
Enrollment address
119 Oakview St
Waverly Hall, GA 31831-3139
Nursing home name
OAK VIEW HOME, INC
Affiliated entity
ETHICA HEALTH

Care Compare: Nursing home

Medicare Care Compare
Listed as
Oak View Home, IncCCN 115576 · All quality measures
Overall star rating
4 of 5
Health inspections
4 of 5
Staffing
4 of 5
Quality measures
4 of 5
Type
Medicare and Medicaid
Ownership
Non profit - Other
Certified
Nov 1, 1994
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
10091.7 residents per day on average
Chain
Ethica Health50 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
11D0866201Oak View119 Oak View St, Waverly Hall, GA 31831Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory

Locations

119 Oakview St
Waverly Hall, GA 31831
Phone (706) 582-2117

Ownership & related parties

All disclosed owners & managing parties 20

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

NameRoleSinceShare
Paul a Cable Individual Managing Control - Governing BodyBoard Member Mar 14, 2003
Ralph Parks Warnock Individual Managing Control - Governing BodyBoard Member Jun 23, 2020
Ronnie D Rollins Individual Managing Control - Governing BodyBoard Member Mar 14, 2003
Organization, Hawkinsville, GA Corporation, Medical provider/supplier, Non-profit Adp of the SNF Jun 9, 2025
Individual Adp of the SNF Jan 1, 2024
Organization, Gray, GA Corporation, Non-profit Adp of the SNF Jun 20, 2025
Individual Adp of the SNF Jan 1, 2025
Kayla Jefferson Individual Operational/Managerial Control Jun 13, 2022
Adp of the SNF Aug 1, 2025
Michael D Satchell Individual Operational/Managerial Control Mar 1, 2025
Adp of the SNF Mar 1, 2025
Organization, Gray, GA LLC, Medical provider/supplier, Non-profit Adp of the SNF Jun 10, 2025
Kathryn Dennis Individual Managing Control - Governing BodyBoard Member Nov 17, 2015
Oak View Home, Inc. Organization, Fortson, GA Created for acquisition, Corporation, For-profit 5% Or Greater Direct Ownership Interest Apr 1, 1973 100%
Adp of the SNF Apr 1, 1973
Jacqueline Pittman Individual Operational/Managerial Control Jan 1, 2026
Managing Control - Governing BodyVice President of Operations Jan 1, 2026
Clinical Services Inc Organization, Gray, GA Corporation, Management services company, Non-profit, Chain home office Operational/Managerial Control Sep 30, 2003 100%
Adp of the SNF Jun 9, 2025
Community Health Systems Inc Organization, Macon, GA Corporation, Non-profit 5% Or Greater Indirect Ownership Interest Sep 30, 2003 100%
Organization, Macon, GA LLC, Non-profit Adp of the SNF Jun 9, 2025
Chelsea Williams Individual Operational/Managerial Control Dec 28, 2022
Health Systems Facilities Inc Organization, Gray, GA Corporation, Holding company, Non-profit 5% Or Greater Direct Ownership Interest Sep 30, 2003 100%
Joseph a Wall Individual Managing Control - Governing BodyBoard Member Mar 14, 2003
Joseph Nichols Individual Managing Control - Governing BodyBoard Member Nov 19, 2024

Owners & managing parties with NPI records 2

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

Facilities with the same owner 50

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

View all 50

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": "1150070400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1695859200000",
    "number": "1740222801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 459",
            "city": "WAVERLY HALL",
            "state": "GA",
            "postal_code": "318310459",
            "telephone_number": "706-582-2117",
            "fax_number": "706-582-2116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "119 OAK VIEW ST",
            "city": "WAVERLY HALL",
            "state": "GA",
            "postal_code": "318310459",
            "telephone_number": "706-582-2117",
            "fax_number": "706-582-2116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOLDEN AGE OAK VIEW HOME LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-12",
        "last_updated": "2023-09-28",
        "certification_date": "2023-09-28",
        "status": "A",
        "authorized_official_last_name": "JEFFERSON",
        "authorized_official_first_name": "KAYLA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "706-582-2117"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "GA",
            "license": "1-072-1703",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "51003285 001",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00142249A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Oak View",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Oak View",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Waverly Hall, GA

Sources for this page

Verify at the official NPI Registry.