Organization Active NPI

Pruitthealth - Jasper, LLC

Doing business as PruittHealth - Jasper

  • Skilled Nursing Facility
  • Jasper, GA
National Provider Identifier
1770530297
Registry record updated Jun 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
1-112-1663 Issued in GA
Legal business name
PRUITTHEALTH - JASPER, LLC
Doing business as
PruittHealth - Jasper
Practice address
1350 E Church St
Jasper, GA 30143-1910
Phone
(706) 253-2441
Fax
(706) 253-2453
NPI assigned
May 29, 2006
Last updated
Jun 3, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2021

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

Authorized official

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 1-112-1663 GA Primary

Addresses

Primary practice location

1350 E Church St
Jasper, GA 30143-1910

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
00142436AMedicaidGA

Other names 1

  • PruittHealth - Jasper Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060501000244 GA Part A Provider - Skilled Nursing Facility 6800806217 Practice locations: Jasper, GA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1770530297. Details of each certification follow.

Skilled nursing facility certification: CCN 115677

Legal name
PRUITTHEALTH - JASPER, LLC
Doing business as
PRUITTHEALTH - JASPER
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Jul 10, 2002
Last certification
May 8, 2025
Beds
60
Ownership / control type
Corporation
Multi-facility organization
Pruitthealth
Organization structure
LLCProprietary
Incorporated
Sep 25, 2007 in GA
Enrollment address
1350 E Church St
Jasper, GA 30143-1910
Nursing home name
PRUITTHEALTH - JASPER
Affiliated entity
PRUITTHEALTH

Care Compare: Nursing home

Medicare Care Compare
Listed as
PruittHealth - JasperCCN 115677 · 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 10, 2002
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
6053.6 residents per day on average
Chain
Pruitthealth95 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
11D0999614Pruitthealth - Jasper, LLC1350 East Church Street, Jasper, GA 30143Certificate of waiverMay 16, 2028

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 9

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

NameRoleSinceShare
United Health Services Inc Organization, Norcross, GA Corporation, For-profit 5% Or Greater Indirect Ownership Interest Sep 25, 2007 99%
Pruitthealth Inc Organization, Toccoa, GA Corporation, For-profit Operational/Managerial Control Sep 25, 2007
Other Jan 12, 2007
Lisa P Hamby Trust Organization, Norcross, GA 5% Or Greater Indirect Ownership Interest Sep 25, 2007 31.54%
Neil Little Pruitt Individual Corporate OfficerChairman and Ceo Sep 25, 2007 100%
Corporate DirectorChairman and Ceo Sep 25, 2007 100%
Operational/Managerial ControlChain Home Office Administrator Sep 25, 2007 100%
OtherAuthorized Official, Cho Admin Sep 25, 2007 100%
Neil L Pruitt Jr Trust Organization, Norcross, GA 5% Or Greater Indirect Ownership Interest Sep 25, 2007 37.38%
Charles E Fallaw Individual W-2 Managing EmployeeFacility Administrator Jun 8, 2015 100%
Uhs-Pruitt Holdings, Inc. Organization, Norcross, GA Corporation, For-profit 5% Or Greater Indirect Ownership Interest Sep 25, 2007 99%
United Health Services of Georgia, Inc. Organization, Norcross, GA Corporation, For-profit 5% Or Greater Direct Ownership Interest Sep 25, 2007 99%
J Paige Pruitt Trust Organization, Norcross, GA 5% Or Greater Indirect Ownership Interest Sep 25, 2007 28.94%

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

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1148860800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1622678400000",
    "number": "1770530297",
    "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",
            "fax_number": "770-931-5278"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1350 E CHURCH ST",
            "city": "JASPER",
            "state": "GA",
            "postal_code": "301431910",
            "telephone_number": "706-253-2441",
            "fax_number": "706-253-2453"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRUITTHEALTH - JASPER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-29",
        "last_updated": "2021-06-03",
        "certification_date": "2021-06-03",
        "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 OF MANAGER",
        "authorized_official_telephone_number": "770-279-6200",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "GA",
            "license": "1-112-1663",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00142436A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PruittHealth - Jasper",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "PruittHealth - Jasper",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Jasper, GA

Sources for this page

Verify at the official NPI Registry.