NPIMap

Organization Active NPI

Suncrest Home Health-Southside, LLC

Doing business as SunCrest Home Health

  • Home Health Agency
  • Atlanta, GA
National Provider Identifier
1871889956
Registry record updated Jul 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
044-293H Issued in GA
Legal business name
SUNCREST HOME HEALTH-SOUTHSIDE, LLC
Doing business as
SunCrest Home Health
Practice address
1039 Ridge Ave SW
Atlanta, GA 30315-1601
Phone
(770) 393-2309
Fax
(770) 668-0522
NPI assigned
Jun 27, 2011
Last updated
Jul 9, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2025

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

Authorized official

Name
Mr. Masresha Kassa, CPA
Title
Cfo
Phone
(404) 564-7009

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X 044-293H GA Primary

Addresses

Primary practice location

1039 Ridge Ave SW
Atlanta, GA 30315-1601

Mailing address

PO Box 6687
Atlanta, GA 30315-0687
Phone (404) 688-1350

Other identifiers 1

IdentifierTypeStateIssuer
003126784AMedicaidGA

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
O20111004000031 GA Part A Provider - Home Health Agency 3870765472 Practice locations: Atlanta, GA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1871889956. Details of each certification follow.

Home health agency certification: CCN 117022

Legal name
SUNCREST HOME HEALTH-SOUTHSIDE, LLC
Doing business as
SUNCREST HOME HEALTH
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Dec 4, 1972
Last certification
Aug 23, 2017
Ownership / control type
Proprietary
Organization structure
LLCProprietary
Incorporated
Apr 27, 2011 in GA
Enrollment address
1039 Ridge Ave SW
Atlanta, GA 30315-1601

Care Compare: Home health agency

Medicare Care Compare
Listed as
Suncrest Home HealthCCN 117022 · All quality measures
Ownership
Proprietary
Certified
Dec 4, 1972
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Home health aide, Physical therapy, Speech pathology, Occupational therapy

National Provider Directory

National Provider Directory

Member of 3

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

Locations

7840 Roswell Rd
#215
Sandy Springs, GA 30350
Phone (615) 627-9267

7840 Roswell Rd
Ste 215
Sandy Springs, GA 30350

510 Hospital Dr
Ste 150
Madison, TN 37115
Phone (615) 865-4232

Ownership & related parties

All disclosed owners & managing parties 3

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

NameRoleSinceShare
David M Williams Individual Corporate DirectorCeo Mar 1, 2021
W-2 Managing EmployeeCeo Mar 1, 2021
Masresha Kassa Individual W-2 Managing EmployeeCfo Apr 1, 2025
Southside Medical Center, Inc. Organization, Atlanta, GA Corporation 5% Or Greater Direct Ownership Interest Mar 1, 2021 100%

Owners & managing parties with NPI records 16

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

View all 16

Practitioners & affiliated clinicians

Practitioners 1

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 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": "1309132800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1752019200000",
    "number": "1871889956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6687",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303150687",
            "telephone_number": "404-688-1350",
            "fax_number": "404-688-2962"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1039 RIDGE AVE SW",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303151601",
            "telephone_number": "770-393-2309",
            "fax_number": "770-668-0522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUNCREST HOME HEALTH-SOUTHSIDE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-06-27",
        "last_updated": "2025-07-09",
        "certification_date": "2025-07-09",
        "status": "A",
        "authorized_official_last_name": "KASSA",
        "authorized_official_first_name": "MASRESHA",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "404-564-7009",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CPA"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "GA",
            "license": "044-293H",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003126784A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SunCrest Home Health",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "SunCrest Home Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.