Active NPI
Monroe Nursing Home Inc
Doing business as Park Place Nursing Facility
- Skilled Nursing Facility
- Monroe, GA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- License
- 11471218
- Legal business name
- MONROE NURSING HOME INC
- Doing business as
- Park Place Nursing Facility
- Practice address
- 1865 Bold Springs Rd NW
Monroe, GA 30656-4605 - Phone
- (770) 267-8677
- Fax
- (770) 267-7831
- NPI assigned
- Jul 30, 2006
- 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
- Mr. E Kenneth Murray Jr.
- Title
- Administrator
- Phone
- (770) 267-8677
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | 11471218 | GA | Primary |
Addresses
Primary practice location
1865 Bold Springs Rd NW
Monroe, GA 30656-4605
Mailing address
1865 Bold Springs Rd NW
Monroe, GA 30656-4605
Phone (770) 267-8677
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00002164A | Medicaid | GA |
Other names 1
- Park Place Nursing Facility
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20030721000020 | GA | Part A Provider - Skilled Nursing Facility | 5597676478 | Practice locations: Monroe, GA |
Skilled nursing facility certification: CCN 115005
- Legal name
- MONROE NURSING HOME INC
- Doing business as
- PARK PLACE NURSING FACILITY
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Nov 11, 1993
- Last certification
- Apr 10, 2025
- Beds
- 175
- Ownership / control type
- Limited Liability Corporation
- Organization structure
- Corporation
- Incorporated
- Oct 1, 1993 in GA
- Enrollment address
- 1865 Bold Springs Rd NW
Monroe, GA 30656-4605 - Nursing home name
- PARK PLACE NURSING FACILITY
- Affiliated entity
- MICHAEL FEIST
Care Compare: Nursing home
Medicare Care Compare- Listed as
- Park Place Nursing Facility
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- For profit - Limited Liability company
- Certified
- Nov 11, 1993
- Medicare certification status
- Active
- Certified beds
- 175
- Chain
- Michael Feist
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 11D0898960 | Park Place Nursing Facility | Certificate of waiver | Mar 15, 2027 |
National Provider Directory
National Provider DirectoryOwnership & related parties
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.
| Name | Role | Since | Share |
|---|---|---|---|
| Michael Vincent Feist | 5% Or Greater Indirect Ownership Interest | Nov 1, 2021 | 100% |
| Corporate Director | Nov 1, 2021 | ||
| Operational/Managerial Control | Nov 1, 2021 | ||
| Park Place Operations Holdings LLC | 5% Or Greater Direct Ownership Interest | Nov 1, 2021 | 100% |
| Park Place Operations Holdings Parent LLC | 5% Or Greater Indirect Ownership Interest | Nov 1, 2021 | 100% |
| Elmer Kenneth Murray | 5% Or Greater Direct Ownership Interest | Oct 2, 1992 | |
| Corporate Director | Jul 21, 2003 | ||
| Elmer Kenneth Murray | Operational/Managerial Control | Jan 1, 1979 |
Practitioners & affiliated clinicians
Practitioners 3
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Internal Medicine Physician
- Morrow, GA
- NPI 1629053277
-
- Internal Medicine Physician
- Monroe, GA
- NPI 1578724886
-
- Family Medicine Physician
- Monroe, GA
- NPI 1073762720
Affiliated clinicians 2
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": "1154217600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1427932800000",
"number": "1972518611",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1865 BOLD SPRINGS RD NW",
"city": "MONROE",
"state": "GA",
"postal_code": "306564605",
"telephone_number": "770-267-8677",
"fax_number": "770-267-7831"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1865 BOLD SPRINGS RD NW",
"city": "MONROE",
"state": "GA",
"postal_code": "306564605",
"telephone_number": "770-267-8677",
"fax_number": "770-267-7831"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MONROE NURSING HOME INC",
"organizational_subpart": "NO",
"enumeration_date": "2006-07-30",
"last_updated": "2015-04-02",
"status": "A",
"authorized_official_last_name": "MURRAY",
"authorized_official_first_name": "E",
"authorized_official_middle_name": "KENNETH",
"authorized_official_title_or_position": "ADMINISTRATOR",
"authorized_official_telephone_number": "770-267-8677",
"authorized_official_name_prefix": "Mr.",
"authorized_official_name_suffix": "Jr."
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": "GA",
"license": "11471218",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00002164A",
"state": "GA"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Park Place Nursing Facility",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Monroe, GA
- Monroe Hma Inc (Walton Regional Medical Center)
- Monroe Hma LLC (Walton Regional Nursing Home)
- Monroe Hma LLC (Clearview Regional Medical Center)
- Monroe Hma Physician Management LLC
- Monroe Hma, LLC (Clearview Regional Medical Center)
- Monroe Optical, Inc.
- Monroe Pediatrics
- Monroe Primary Care LLC
- Monroe Sports and Family Chiropractic,Inc (Alcovy Sports and Family Chiropractic)
- Monroe Veterinary Clinic Inc
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2015; 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.