CG Madison LLC
Organization Active NPI Skilled Nursing Facility · Madison, FL
NPI 1801897541 · NPPES record last updated Sep 21, 2023
Key facts
- NPI
- 1801897541
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Skilled Nursing Facility 314000000X
- Legal business name
- CG MADISON LLC
- Practice address
- 2481 W US 90
Madison, FL 32340-4306 - Phone
- (850) 973-4880
- Fax
- (850) 973-2667
- NPI assigned
- Aug 3, 2005
- Organization subpart
- No
Authorized official
- Name
- Mr. Joseph D. Mitchell
- Title
- President
- Phone
- (850) 386-2522
Owners & managing parties with NPI records 1
-
Daniel B Perkins, MD
Facilities with the same owner 19
Affiliated clinicians 1
-
Daniel B Perkins, MD
Medicare Care Compare: Nursing home
- Listed as
- Madison Health and Rehabilitation Center
- Overall star rating
- ★★★★★ 5 of 5
- Health inspections
- ★★★★★ 5 of 5
- Staffing
- ★★★★☆ 4 of 5
- Quality measures
- ★★☆☆☆ 2 of 5
- Type
- Medicare and Medicaid
- Ownership
- For profit - Limited Liability company
- Certified
- Jul 1, 1993
- Medicare certification status
- Active
- Certified beds
- 60 · 54.9 residents per day on average
- Chain
- Summit Care
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 10D0724952 | CG Madison, LLC | Certificate of waiver | Aug 31, 2026 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in FL
Skilled nursing facility certification: CCN 105807
- Legal name
- CG MADISON LLC
- Doing business as
- MADISON HEALTH AND REHABILITATION CENTER
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Jul 1, 1993
- Last certification
- Aug 15, 2024
- Beds
- 60
- Ownership / control type
- Limited Liability Corporation
- Organization structure
- LLC · Proprietary
- Enrollment address
- 2481 West US 90
Madison Health and Rehabilitation Center
Madison, FL 32340-4306 - Nursing home name
- MADISON HEALTH AND REHABILITATION CENTER
- Affiliated entity
- SUMMIT CARE
All disclosed owners & managing parties 25
| Name | Role | Since | Share |
|---|---|---|---|
| Seam Trust |
5% Or Greater Indirect Ownership Interest | Aug 4, 2023 | 21.39% |
| John McManus |
Corporate Director |
Aug 4, 2023 | |
| Adp of the SNF | Aug 3, 2023 | ||
| Joseph Mitchell |
5% Or Greater Direct Ownership Interest | Mar 1, 1998 | 30.25% |
| |
Adp of the SNF | Aug 4, 2023 | |
| |
Indirect Ownership Interest | Aug 2, 2023 | 1.13% |
| Daniel B Perkins |
Adp of the SNF | Feb 16, 2026 | |
| Madison SNF Operations LLC |
5% Or Greater Direct Ownership Interest | Aug 2, 2023 | 45% |
| Alan Davis |
5% Or Greater Direct Ownership Interest | Jan 1, 2014 | 24.75% |
| Corporate Officer |
Jan 1, 2014 | 24.75% | |
| |
Indirect Ownership Interest | Aug 2, 2023 | 2.23% |
| |
Adp of the SNF | Aug 4, 2023 | |
| |
Adp of the SNF | Mar 1, 2004 | |
| |
Adp of the SNF | Dec 19, 2025 | |
| CH Summit Care Holdings LLC |
5% Or Greater Indirect Ownership Interest | Aug 2, 2023 | 20.25% |
| |
Indirect Ownership Interest | Aug 2, 2023 | 1.13% |
| |
Adp of the SNF | Aug 4, 2023 | |
| |
Indirect Ownership Interest | Aug 2, 2023 | 1.13% |
| Paul Kovary |
Operational/Managerial Control | Oct 11, 2021 | |
| Adp of the SNF | Dec 21, 2025 | ||
| SK Summit Care II Holdings LLC |
5% Or Greater Indirect Ownership Interest | Aug 2, 2023 | 22.5% |
| Yisroel E Herzka |
5% Or Greater Indirect Ownership Interest | Aug 2, 2023 | 20.25% |
| Summit Care Management LLC |
Operational/Managerial Control | Aug 4, 2023 | 100% |
| Adp of the SNF | Aug 4, 2023 | ||
| |
Adp of the SNF | Dec 19, 2025 | |
| |
Indirect Ownership Interest | Aug 2, 2023 | 1.13% |
| |
Adp of the SNF | Aug 3, 2023 | |
| |
Adp of the SNF | Aug 4, 2023 | |
| Summit Care Group II Operations Holdings LLC |
5% Or Greater Indirect Ownership Interest | Aug 2, 2023 | 45% |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20050207000288 | FL | Part a Provider - Skilled Nursing Facility | 5597716688 | Practice locations: Madison, FL |
National Provider Directory
Locations
2481 W US 90
Madison, FL 32340
Phone (850) 877-4115
Networks
- Freedom Health HMO Network
- Optimum HealthCare HMO Network
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | FL | Yes |
Addresses
Primary practice location
2481 W US 90
Madison, FL 32340-4306
Mailing address
2123 Centre Pointe Blvd
Tallahassee, FL 32308-4930
Phone (850) 386-2831
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 021346200 | Medicaid | FL |
Other names
- Madison Health and Rehabilitation Center
Other providers in Madison, FL
- Jennifer E Brown
- Michelle Brown
- Randall Maxie Buchanan Jr.
- Cardiology and Internal Medicine Group of North Florida P a
- Carewell LLC
- George Elton Cherry
- Thomas Wayne Conger
- County of Madison Office Clerk Board County Commissioners
- Katelynn Mae Croft
- Crystal Fountain Home Services LLC
All providers in Madison, FL · Skilled Nursing Facility in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 21, 2023. 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.