Organization Active NPI

Monroe Nursing Home Inc

Doing business as Park Place Nursing Facility

  • Skilled Nursing Facility
  • Monroe, GA
National Provider Identifier
1972518611
Registry record updated Apr 2, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
11471218 Issued in GA
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

Updated by the provider on Apr 2, 2015

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)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
00002164AMedicaidGA

Other names 1

  • Park Place Nursing Facility Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
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
CorporationProprietary
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 FacilityCCN 115005 · All quality measures
Overall star rating
2 of 5
Health inspections
2 of 5
Staffing
2 of 5
Quality measures
3 of 5
Type
Medicare and Medicaid
Ownership
For profit - Limited Liability company
Certified
Nov 11, 1993
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
175168.7 residents per day on average
Chain
Michael Feist7 facilities in the chain

Processed by Care Compare on Aug 1, 2026.

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
11D0898960Park Place Nursing Facility1865 Bold Springs Rd NW, Monroe, GA 30656Certificate of waiverMar 15, 2027

National Provider Directory

National Provider Directory

Ownership & 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.

NameRoleSinceShare
Michael Vincent Feist Individual 5% Or Greater Indirect Ownership InterestMember LLC Nov 1, 2021 100%
Corporate DirectorDirector Nov 1, 2021
Operational/Managerial ControlMember of LLC Nov 1, 2021
Park Place Operations Holdings LLC Organization, Monroe, GA Created for acquisition, LLC 5% Or Greater Direct Ownership Interest Nov 1, 2021 100%
Park Place Operations Holdings Parent LLC Organization, Monroe, GA Created for acquisition, LLC 5% Or Greater Indirect Ownership Interest Nov 1, 2021 100%
Elmer Kenneth Murray Individual 5% Or Greater Direct Ownership Interest Oct 2, 1992
Corporate Director Jul 21, 2003
Elmer Kenneth Murray Individual Operational/Managerial ControlAdministrator 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.

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

Sources for this page

Verify at the official NPI Registry.