NPIMap

Organization Active NPI

Suncrest Home Health of Georgia, Inc

  • Home Health Agency
  • Fayetteville, GA
National Provider Identifier
1801044003
Registry record updated Jun 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
126-183 Issued in GA
Legal business name
SUNCREST HOME HEALTH OF GEORGIA, INC
Practice address
320 Lanier Ave W Ste 240&250
Fayetteville, GA 30214-1600
Phone
(770) 253-4317
Fax
(770) 253-4393
NPI assigned
Sep 3, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2021

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

Authorized official

Name
Mr. Nicholas Gachassin III
Title
Secretary/Treasurer
Phone
(337) 233-1307

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X 126-183 GA Primary

Addresses

Primary practice location

320 Lanier Ave W Ste 240&250
Fayetteville, GA 30214-1600

Mailing address

PO Box 51266
Lafayette, LA 70505-1266
Phone (337) 233-1307

Other practice location 1

246 Bullsboro Dr Ste E
Newnan, GA 30263-3167
Phone (770) 253-4317

Other identifiers 1

IdentifierTypeStateIssuer
000770272BMedicaidGA

Other names 1

  • SunCrest Home Health Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100219000177 GA Part A Provider - Home Health Agency 9032271796 Practice locations: Fayetteville, GA; Griffin, GA

Home health agency certification: CCN 117105

Legal name
SUNCREST HOME HEALTH OF GEORGIA, INC.
Doing business as
SUNCREST HOME HEALTH
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Mar 10, 1993
Last certification
Apr 19, 2018
Ownership / control type
Proprietary
Organization structure
CorporationProprietary
Incorporated
Jan 30, 2008 in GA
Enrollment address
320 Lanier Ave W
Suite 240&250
Fayetteville, GA 30214-7547

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Home health agency

Medicare Care Compare
Listed as
Adoration Home HealthCCN 117105
Overall star rating
3.5 of 5
Ownership
Proprietary
Certified
Mar 10, 1993
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

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
11D0857652Suncrest Home Health of Georgia, Inc320 Lanier Avenue West Suite 240 & 250, Fayetteville, GA 30214Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory
Tax ID family
Suncrest Home Health of Georgia 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.

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

2131 Pace St
#2133
Covington, GA 30014

320 Lanier Ave W
#240250
Fayetteville, GA 30214

2927 Etheridge Mill Rd
Griffin, GA 30224
Phone (770) 229-5342

3000 Corporate Center Dr
Ste 260
Morrow, GA 30260
Phone (770) 991-8662

246 Bullsboro Dr
Ste E
Newnan, GA 30263
Phone (770) 253-4317

29 Upper Riverdale Rd SW
Ste 130
Riverdale, GA 30274
Phone (770) 991-8662

9 Park of Commerce Blvd
Ste 201
Savannah, GA 31405
Phone (912) 354-7984

Ownership & related parties

All disclosed owners & managing parties 11

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

NameRoleSinceShare
Unitedhealth Group Incorporated Organization, Minnetonka, MN Corporation 5% Or Greater Indirect Ownership Interest Feb 22, 2023 100%
Omni Home Health Holdings Inc Organization, Lafayette, LA Corporation 5% Or Greater Indirect Ownership Interest Dec 7, 2013 100%
Wendy S Daigle Individual Corporate DirectorDirector, Licensure & Regulatory Oct 1, 2022
LHC Group Inc Organization, Lafayette, LA Corporation 5% Or Greater Indirect Ownership Interest Apr 1, 2018 100%
Melissa Hutcheson Individual W-2 Managing EmployeeAdministrator Aug 24, 2018
Operational/Managerial ControlAdministrator Aug 24, 2018
Joshua Lee Proffitt Individual Corporate OfficerPresident Aug 1, 2012
Almost Family, Inc. Organization, Lafayette, LA Corporation 5% Or Greater Indirect Ownership Interest Dec 7, 2013 100%
National Health Industries, Inc. Organization, Lafayette, LA Corporation 5% Or Greater Indirect Ownership Interest Dec 7, 2013 100%
Amy Cormier Individual Corporate DirectorDirector of Managed Care May 1, 2025
Sun Crest Healthcare Inc Organization, Lafayette, LA Corporation 5% Or Greater Direct Ownership Interest Dec 7, 2013 100%
Sylvia Faye Johnson Boston Individual W-2 Managing EmployeeDirector of Nursing Mar 30, 2021
Operational/Managerial ControlDirector of Nursing Mar 30, 2021

Facilities with the same owner 111

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

View all 111

Practitioners & affiliated clinicians

Affiliated clinicians 39

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 39

NPI Registry JSON

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

{
    "created_epoch": "1220400000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1623110400000",
    "number": "1801044003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 51266",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705051266",
            "telephone_number": "337-233-1307",
            "fax_number": "337-233-5764"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 LANIER AVE W STE 240&250",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302141600",
            "telephone_number": "770-253-4317",
            "fax_number": "770-253-4393"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "246 Bullsboro Dr Ste E",
            "address_purpose": "LOCATION",
            "city": "Newnan",
            "state": "GA",
            "postal_code": "302633167",
            "country_code": "US",
            "telephone_number": "770-253-4317",
            "fax_number": "770-253-4393",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SUNCREST HOME HEALTH OF GEORGIA, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-03",
        "last_updated": "2021-06-08",
        "certification_date": "2021-06-08",
        "status": "A",
        "authorized_official_last_name": "GACHASSIN",
        "authorized_official_first_name": "NICHOLAS",
        "authorized_official_title_or_position": "SECRETARY/TREASURER",
        "authorized_official_telephone_number": "337-233-1307",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "III"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "GA",
            "license": "126-183",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000770272B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SunCrest Home Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fayetteville, GA

Sources for this page

Verify at the official NPI Registry.