Organization Active NPI

Pruitthealth Hospice, Inc.

Doing business as PruittHealth Hospice - Rome

  • Community Based Hospice Care Agency
  • Rome, GA
National Provider Identifier
1841238441
Registry record updated Jul 7, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
Legal business name
PRUITTHEALTH HOSPICE, INC.
Doing business as
PruittHealth Hospice - Rome
Practice address
35 Three Rivers Dr NE
Rome, GA 30161-4998
Phone
(706) 236-4706
NPI assigned
Jun 4, 2006
Last updated
Jul 7, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2014

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

Authorized official

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X NU Primary

Addresses

Primary practice location

35 Three Rivers Dr NE
Rome, GA 30161-4998

Mailing address

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

Other names 1

  • PruittHealth Hospice - Rome Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20060901000158 GA Part A Provider - Hospice 2264344217 Practice locations: Rome, GA
O20190702003113 GA Part B Supplier - Clinic/Group Practice 2264344217 Receives reassigned benefits from 45 practitioners
12 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Watkinsville, GA; Augusta, GA; Valdosta, GA; Union City, GA; Swainsboro, GA; Savannah, GA; Rome, GA; Macon, GA…

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1841238441. Details of each certification follow.

Hospice certification: CCN 111645

Legal name
PRUITTHEALTH HOSPICE INC
Doing business as
PRUITTHEALTH HOSPICE- ROME
Certification status
Active
Provider type (POS)
Hospice
Participating since
Feb 14, 2007
Last certification
Feb 5, 2020
Ownership / control type
Proprietary - Corporation
Organization structure
CorporationProprietary
Incorporated
Oct 14, 1993 in GA
Enrollment address
35 Three Rivers Dr NE
Rome, GA 30161-4998

Other NPIs with the same Medicare PAC ID 17

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

View all 17

Other NPIs on the same Medicare enrollment 12

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Care Compare: Hospice

Medicare Care Compare
Listed as
Pruitthealth Hospice-RomeCCN 111645 · All quality measures
Ownership
For-Profit
Certified
Feb 14, 2007
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory
Tax ID family
Pruitthealth Hospice Inc26 organizations share this tax ID, including this one

Other organizations with this tax ID 25

Organizations that report the same tax identification number in the National Provider Directory.

View all 25

Ownership & related parties

All disclosed owners & managing parties 13

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

NameRoleSinceShare
Kaitlin Gulledge Individual W-2 Managing EmployeeAd; Mar 19, 2023
United Health Services Inc Organization, Norcross, GA For-profit 5% Or Greater Direct Ownership Interest Jan 1, 2022
Philip W. Small Individual Corporate DirectorDirector Sep 17, 2013
Pruitthealth Inc Organization, Norcross, GA For-profit 5% Or Greater Direct Ownership Interest Jan 1, 2022
Operational/Managerial Control Jan 2, 2006
Lisa P Hamby Trust Organization, Norcross, GA 5% Or Greater Indirect Ownership Interest Jan 2, 2006 31.65%
Teresa Burns Individual W-2 Managing EmployeeAdministrator May 22, 2017
Neil Little Pruitt Individual Corporate OfficerChairman and Ceo Mar 3, 2003
Corporate DirectorDirector Mar 3, 2003
OtherChain Home Office Admin., Ao Mar 3, 2003
Neil L Pruitt Jr Trust Organization, Norcross, GA 5% Or Greater Indirect Ownership Interest Jan 2, 2006 35.93%
Nancy W Pruitt Individual Corporate OfficerSecretary Oct 14, 1993
Uhs-Pruitt Holdings, Inc. Organization, Norcross, GA Non-profit 5% Or Greater Indirect Ownership Interest Jan 2, 2006 100%
Thomas R Beddingfield Individual Corporate DirectorDirector Sep 17, 2013
United Health Services of Georgia, Inc. Organization, Norcross, GA For-profit 5% Or Greater Indirect Ownership Interest Jan 2, 2006 100%
J Paige Pruitt Trust Organization, Norcross, GA 5% Or Greater Indirect Ownership Interest Jan 2, 2006 31.32%

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 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.

Affiliated clinicians 4

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": "1149379200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1404691200000",
    "number": "1841238441",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35 THREE RIVERS DR NE",
            "city": "ROME",
            "state": "GA",
            "postal_code": "301614998",
            "telephone_number": "706-236-4706"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRUITTHEALTH HOSPICE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-04",
        "last_updated": "2014-07-07",
        "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",
        "authorized_official_telephone_number": "770-279-6200",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PruittHealth Hospice - Rome",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Rome, GA

Sources for this page

Verify at the official NPI Registry.