Carrollton Manor Inc

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

1-022-1170 Issued in GA

Legal business name

CARROLLTON MANOR INC

Practice address

2455 Oak Grove Church Rd
Carrollton, GA 30117-9513

Phone

(770) 834-1737

Fax

(770) 836-1223

NPI assigned

Jun 15, 2005

Last updated

Aug 22, 2020By 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

Mrs. Evelyn Thompson

Title

Administrator

Phone

(770) 834-1737

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1922003177. Details of each certification follow.

• CCN 115638 Skilled nursing facility · Active · Details

Skilled nursing facility certification: CCN 115638

Legal name

CARROLLTON MANOR INC

Doing business as

CARROLLTON MANOR INC

Certification status

Active

Provider type (POS)

Nursing home – SNF/NF dual certification

Participating since

Mar 1, 1997

Last certification

Apr 25, 2025

Beds

100

Ownership / control type

Corporation

Organization structure

CorporationProprietary

Incorporated

Sep 15, 1978 in GA

Enrollment address

2455 Oak Grove Church Rd
Carrollton, GA 30117-9513

Nursing home name

CARROLLTON MANOR, INCORPORATED

Listed as

Carrollton Manor, IncorporatedCCN 115638 · All quality measures

Overall star rating

1 of 5

Health inspections

1 of 5

Staffing

2 of 5

Quality measures

1 of 5

Type

Medicare and Medicaid

Ownership

For profit - Corporation

Certified

Mar 1, 1997

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

10085.4 residents per day on average

Abuse citation

Cited for abuse (Care Compare abuse icon)

Processed by Care Compare on Aug 1, 2026.

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

All disclosed owners & managing parties 5

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

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.

• Mark L Lipham, MD

  • Internal Medicine Physician
  • Carrollton, GA
  • NPI 1437192697
  NPD (past)

Affiliated clinicians 1

Clinicians who list this facility as an affiliation in Medicare Care Compare.

• Mark L Lipham, MD

  • Internal Medicine Physician
  • Carrollton, GA
  • NPI 1437192697

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1118793600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1922003177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2398",
            "city": "CARROLLTON",
            "state": "GA",
            "postal_code": "301120044",
            "telephone_number": "770-834-1737",
            "fax_number": "770-836-1223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2455 OAK GROVE CHURCH RD",
            "city": "CARROLLTON",
            "state": "GA",
            "postal_code": "301179513",
            "telephone_number": "770-834-1737",
            "fax_number": "770-836-1223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARROLLTON MANOR INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-15",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "THOMPSON",
        "authorized_official_first_name": "EVELYN",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "770-834-1737",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "GA",
            "license": "1-022-1170",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00140852A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Carrollton Family Dentistry LLC
• Carrollton Optics LLC
• Carrollton Orthopaedic Clinic PC (Carrollton Orthopaedic Clinic)
• Carrollton Orthopaedic Clinic PC (Orthowest)
• Carrollton Orthopaedic Clinic PC (Carrollton Orthopaedic Clinic)
• Carrollton Orthopaedic Surgery Center

• Skilled Nursing Facility in Carrollton, GA
• Providers in Carrollton, 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 Aug 22, 2020; 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.

Verify at the official NPI Registry.