Providence Post Acute LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

PROVIDENCE POST ACUTE LLC

Practice address

1011 S Green St
Thomaston, GA 30286-4643

Phone

(706) 647-6693

NPI assigned

Apr 8, 2026

Last updated

Apr 8, 2026By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Kenneth Funk

Title

Member of LLC

Phone

(415) 310-8307

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1775606400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1775606400000",
    "number": "1851233837",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1011 S GREEN ST",
            "city": "THOMASTON",
            "state": "GA",
            "postal_code": "302864643",
            "telephone_number": "706-647-6693"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1011 S GREEN ST",
            "city": "THOMASTON",
            "state": "GA",
            "postal_code": "302864643",
            "telephone_number": "706-647-6693"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROVIDENCE POST ACUTE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-04-08",
        "last_updated": "2026-04-08",
        "certification_date": "2026-04-08",
        "status": "A",
        "authorized_official_last_name": "FUNK",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_title_or_position": "MEMBER OF LLC",
        "authorized_official_telephone_number": "415-310-8307"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melanie Robin Phillips, PHARMD
• Andrea Ruth Pinnow, MSW, LCSW
• Practice Equity, LLC (Douglas S. Johnson, DMD)
• Angelic J Prather, D.C.
• Providence Health and Rehabilitation Center, Inc.
• Providence SNF Operator LLC
• Kendra Latrice Raines, APRN
• Rayneb Medical
• Red Clay Ventures, LLC (Thomaston Prescription Shop)
• Rehab Potential, LLC

• Skilled Nursing Facility in Thomaston, GA
• Providers in Thomaston, GA by specialty
• Skilled Nursing Facility in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.