Pruitthealth - Columbia, LLC
Organization Active NPI Skilled Nursing Facility · Columbia, SC
NPI 1790732212 · NPPES record last updated Jun 30, 2014
Key facts
- NPI
- 1790732212
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Skilled Nursing Facility 314000000X
- License
- NCF-880 (SC)
- Legal business name
- PRUITTHEALTH - COLUMBIA, LLC
- Practice address
- 2451 Forest Dr
Columbia, SC 29204-2026 - Phone
- (803) 254-5960
- NPI assigned
- May 29, 2006
- Organization subpart
- No
Authorized official
- Name
- Mr. Neil L Pruitt
- Title
- Chairman and Ceo
- Phone
- (770) 279-6200
Facilities with the same owner 122
Affiliated clinicians 1
-
Jason K Barber, M.D.
Medicare Care Compare: Nursing home
- Listed as
- PruittHealth- Columbia
- Overall star rating
- ★☆☆☆☆ 1 of 5
- Health inspections
- ★☆☆☆☆ 1 of 5
- Staffing
- ★★★★☆ 4 of 5
- Quality measures
- ★★★☆☆ 3 of 5
- Type
- Medicare and Medicaid
- Ownership
- For profit - Corporation
- Certified
- Jan 1, 1967
- Medicare certification status
- Active
- Certified beds
- 144 · 133.8 residents per day on average
- Chain
- Pruitthealth
- Penalties (3 years)
- 2 · fines totaling $48,523
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 42D0981995 | Pruitthealth - Columbia, LLC | Certificate of waiver | Jan 11, 2027 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in SC
Skilled nursing facility certification: CCN 425013
- Legal name
- PRUITTHEALTH-COLUMBIA LLC
- Doing business as
- PRUITTHEALTH- COLUMBIA
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Jan 1, 1967
- Last certification
- Aug 1, 2024
- Beds
- 144
- Ownership / control type
- Corporation
- Multi-facility organization
- Pruitt Health Corporation
- Organization structure
- LLC · Proprietary
- Incorporated
- Oct 28, 2004 in SC
- Enrollment address
- 2451 Forest Dr
Columbia, SC 29204-2026 - Nursing home name
- PRUITTHEALTH- COLUMBIA
- Affiliated entity
- PRUITTHEALTH
All disclosed owners & managing parties 9
| Name | Role | Since | Share |
|---|---|---|---|
| Patricia Lee |
W-2 Managing Employee |
Oct 18, 2013 | |
| United Health Services Inc |
5% Or Greater Indirect Ownership Interest | Oct 28, 2004 | 99% |
| Pruitthealth Inc |
Other | Oct 28, 2004 | |
| Lisa P Hamby Trust |
5% Or Greater Indirect Ownership Interest | Jan 2, 2006 | 31.74% |
| Neil Little Pruitt |
Corporate Officer |
Oct 28, 2004 | 100% |
| Corporate Director |
Oct 28, 2004 | 100% | |
| Operational/Managerial Control |
Oct 28, 2004 | ||
| Other |
Oct 28, 2004 | 100% | |
| United Health Services of South Carolina Inc |
5% Or Greater Direct Ownership Interest | Oct 28, 2004 | 99% |
| Neil L Pruitt Jr Trust |
5% Or Greater Indirect Ownership Interest | Jan 2, 2006 | 37.03% |
| Uhs-Pruitt Holdings, Inc. |
5% Or Greater Indirect Ownership Interest | Jan 2, 2006 | 99% |
| J Paige Pruitt Trust |
5% Or Greater Indirect Ownership Interest | Jan 2, 2006 | 29.09% |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20050225000175 | SC | Part a Provider - Skilled Nursing Facility | 8325091713 | Practice locations: Columbia, SC |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | NCF-880 | SC | Yes |
Addresses
Primary practice location
2451 Forest Dr
Columbia, SC 29204-2026
Mailing address
1626 Jeurgens CT
Norcross, GA 30093-2219
Phone (770) 279-6200
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 289473 | Medicaid | SC |
Other names
- PruittHealth - Columbia
Other providers in Columbia, SC
- Provident Place
- Providing Promises LLC
- Provision Healthcare, LLC
- Jessica Erin Hyatt Pruett
- Sallie I Prugh
- Pruitthealth Home Health, Inc.
- Pruitthealth Hospice, Inc.
- Pruitthealth Hospice, Inc.
- Pruitthealth Therapy Services, Inc.
- Jamion Pryor
All providers in Columbia, SC · Skilled Nursing Facility in South Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 30, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.