Active NPI
MGHP-Brentwood LLC
- Skilled Nursing Facility
- Waynesboro, GA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- Legal business name
- MGHP-BRENTWOOD LLC
- Practice address
- 115 Brentwood Dr
Waynesboro, GA 30830-4519 - Phone
- (706) 554-4425
- NPI assigned
- Mar 10, 2023
- Last updated
- Mar 10, 2023
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- David A Parker
- Title
- Member of LLC
- Phone
- (678) 480-7564
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | Primary |
Addresses
Primary practice location
115 Brentwood Dr
Waynesboro, GA 30830-4519
Mailing address
115 Brentwood Dr
Waynesboro, GA 30830-4519
Phone (706) 554-4425
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20230502003245 | GA | Part A Provider - Skilled Nursing Facility | 9234594920 | Practice locations: Waynesboro, GA |
NPI to CCN mapping 1
The Medicare certification numbers (CCNs) connected to NPI 1811698590. Details of each certification follow.
Skilled nursing facility certification: CCN 115361
- Legal name
- MGHP-BRENTWOOD LLC
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Apr 1, 1989
- Last certification
- Jun 15, 2025
- Beds
- 103
- Ownership / control type
- Corporation
- Organization structure
- LLC
- Enrollment address
- 115 Brentwood Dr
Waynesboro, GA 30830-4519 - Nursing home name
- BRENTWOOD HEALTH CENTER BY HARBORVIEW
- Affiliated entity
- HARBORVIEW HEALTH SYSTEMS
Care Compare: Nursing home
Medicare Care Compare- Listed as
- Brentwood Health Center by Harborview
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- For profit - Corporation
- Certified
- Apr 1, 1989
- Medicare certification status
- Active
- Certified beds
- 103
- Chain
- Harborview Health Systems
National Provider Directory
National Provider DirectoryOwnership & related parties
All disclosed owners & managing parties 16
As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.
| Name | Role | Since | Share |
|---|---|---|---|
| Spencer Windham | 5% Or Greater Indirect Ownership Interest | May 1, 2023 | 12.5% |
| Operational/Managerial Control | May 1, 2023 | ||
| Adp of the SNF | May 1, 2023 | ||
| Indirect Ownership Interest | May 1, 2023 | 12.5% | |
| Windcorp Consultants LLC | Adp of the SNF | May 1, 2023 | |
| David Andrew Parker | 5% Or Greater Indirect Ownership Interest | May 1, 2023 | |
| Operational/Managerial Control | May 1, 2023 | ||
| Adp of the SNF | May 1, 2023 | ||
| Indirect Ownership Interest | May 1, 2023 | 12.5% | |
| William C Davis | 5% Or Greater Indirect Ownership Interest | May 1, 2023 | 12.5% |
| Operational/Managerial Control | May 1, 2023 | ||
| Adp of the SNF | May 1, 2023 | ||
| Indirect Ownership Interest | May 1, 2023 | 12.5% | |
| Adp of the SNF | May 1, 2023 | ||
| MGHP Re Brentwood LLC | Adp of the SNF | May 1, 2023 | |
| Adp of the SNF | May 1, 2023 | ||
| Parker Financial Solutions, LLC | Adp of the SNF | May 1, 2023 | |
| Crossroads Medical Management, Inc. | Adp of the SNF | May 1, 2023 | |
| David Orne | 5% Or Greater Indirect Ownership Interest | May 1, 2023 | 12.5% |
| Operational/Managerial Control | May 1, 2023 | ||
| Adp of the SNF | May 1, 2023 | ||
| Indirect Ownership Interest | May 1, 2023 | 12.5% | |
| James R Westbury | 5% Or Greater Indirect Ownership Interest | May 1, 2023 | 25% |
| Operational/Managerial Control | May 1, 2023 | ||
| Adp of the SNF | May 1, 2023 | ||
| Indirect Ownership Interest | May 1, 2023 | 25% | |
| Ashton Windham | 5% Or Greater Indirect Ownership Interest | May 1, 2023 | 12.5% |
| Operational/Managerial Control | May 1, 2023 | ||
| Adp of the SNF | May 1, 2023 | ||
| Indirect Ownership Interest | May 1, 2023 | 12.5% | |
| Elise Stafford | Adp of the SNF | Feb 9, 2024 | |
| William C Davis III | 5% Or Greater Indirect Ownership Interest | May 1, 2023 | 12.5% |
| Operational/Managerial Control | May 1, 2023 | ||
| Adp of the SNF | May 1, 2023 | ||
| Indirect Ownership Interest | May 1, 2023 | 12.5% | |
| Mid Ga Health Properties LLC | Adp of the SNF | May 1, 2023 | |
| Direct Ownership Interest | May 1, 2023 | 100% | |
| Davis & Cleveland Cpas, LLC | Adp of the SNF | May 1, 2023 |
Practitioners & affiliated clinicians
Practitioners 2
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.
-
- Family Medicine Physician
- Waynesboro, GA
- NPI 1962445841
-
- Internal Medicine Physician
- Martinez, GA
- NPI 1093758724
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": "1678406400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1678406400000",
"number": "1811698590",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "115 BRENTWOOD DR",
"city": "WAYNESBORO",
"state": "GA",
"postal_code": "308304519",
"telephone_number": "706-554-4425"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "115 BRENTWOOD DR",
"city": "WAYNESBORO",
"state": "GA",
"postal_code": "308304519",
"telephone_number": "706-554-4425"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MGHP-BRENTWOOD LLC",
"organizational_subpart": "NO",
"enumeration_date": "2023-03-10",
"last_updated": "2023-03-10",
"certification_date": "2023-03-10",
"status": "A",
"authorized_official_last_name": "PARKER",
"authorized_official_first_name": "DAVID",
"authorized_official_middle_name": "A",
"authorized_official_title_or_position": "MEMBER OF LLC",
"authorized_official_telephone_number": "678-480-7564"
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Waynesboro, GA
- Lauren Shaw McMillan, ANP-C
- Medical Specialists (Medical Associates)
- Medical Specialists, Inc. (Medical Associates of Sardis)
- Denise Blanchard Meeks, RN
- Wilton Clinton Meeks III, RPH
- Robin Dubose Mizell, RN
- Dontae Morgan, RBT
- Charles Graybill Moye Sr., RPH
- Varan Mungin, PHARM.D.
- Neighborhood Improvement Project Inc
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.