NPIMap

Organization Active NPI

Palm Gardens Health and Rehabilitation, LLC

  • Skilled Nursing Facility
  • Mobile, AL
National Provider Identifier
1972941391
Registry record updated Oct 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
PALM GARDENS HEALTH AND REHABILITATION, LLC
Practice address
3104 Dauphin SQ Connector
Mobile, AL 36607-2513
Phone
(251) 450-2800
Fax
(251) 450-2802
NPI assigned
Jun 7, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2020

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

Authorized official

Name
Phillip Cody Long
Title
Vice President
Phone
(205) 391-3600

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

3104 Dauphin SQ Connector
Mobile, AL 36607-2513

Mailing address

3104 Dauphin SQ Connector
Mobile, AL 36607-2513
Phone (251) 450-2800

Other identifiers 1

IdentifierTypeStateIssuer
152549MedicaidAL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130804000000 AL Part A Provider - Skilled Nursing Facility 5092957019 Practice locations: Mobile, AL

Skilled nursing facility certification: CCN 015403

Legal name
PALM GARDENS HEALTH AND REHABILITATION LLC
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Oct 4, 1989
Last certification
Jul 16, 2021
Beds
100
Ownership / control type
Corporation
Multi-facility organization
NHS
Most recent change of ownership
Jul 1, 2013
Organization structure
LLCProprietary
Incorporated
Mar 29, 2013 in AL
Enrollment address
3104 Dauphin SQ Connector
Mobile, AL 36607-2513
Nursing home name
PALM GARDENS HEALTH AND REHABILITATION, LLC
Affiliated entity
NHS MANAGEMENT

Care Compare: Nursing home

Medicare Care Compare
Listed as
Palm Gardens Health and Rehabilitation, LLCCCN 015403
Overall star rating
5 of 5
Health inspections
5 of 5
Staffing
4 of 5
Quality measures
4 of 5
Type
Medicare and Medicaid
Ownership
For profit - Corporation
Certified
Oct 4, 1989
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
10089.8 residents per day on average
Chain
NHS Management43 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
01D2066637Palm Gardens Health and Rehabilitation LLC3104 Dauphin Square Connector, Mobile, AL 36607Certificate of waiverSep 30, 2027

National Provider Directory

National Provider Directory
Tax ID family
Cogburn Health Rehabilitation-Midtown Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 17

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

NameRoleSinceShare
James Norman Estes Jr TR Organization, Vestavia, AL 5% Or Greater Indirect Ownership Interest Jun 30, 2013 6.25%
Lynn S Rasco Individual Corporate DirectorDirector of Qa/Corp Compliance Ofcr Jul 1, 2022 33%
Operational/Managerial ControlDirector of Qa/Corp Compliance Ofcr Jul 1, 2022 33%
Jennifer Lee Estes TR 031093 Organization, Vestavia, AL 5% Or Greater Indirect Ownership Interest Jun 30, 2013 6.25%
James Norman Estes Individual 5% Or Greater Indirect Ownership InterestPresident/Treasurer Mar 29, 2013 51%
Corporate OfficerPresident/Treasurer Mar 29, 2013 100%
Holding Facilities Group LLC Organization, Tuscaloosa, AL LLC, Holding company, For-profit 5% Or Greater Security Interest Jul 1, 2013
Starann Macdonald-Lamier Individual Corporate DirectorRegional Administrator Aug 28, 2023 33%
W-2 Managing EmployeeAdministrator Sep 22, 2023 100%
Operational/Managerial ControlRegional Administrator Aug 28, 2023 33%
Phillip Cody Long Individual Corporate OfficerVice President/Secretary Oct 1, 2019
Other Jan 1, 2022 49%
Jennifer E Agee Family Dynasty TR No 2 Organization, Tuscaloosa, AL 5% Or Greater Indirect Ownership Interest Mar 29, 2013 18.25%
Northport Holding Operations, LLC Organization, Tuscaloosa, AL LLC, Holding company, For-profit 5% Or Greater Direct Ownership Interest Mar 29, 2013 100%
Alice P. Simmons Individual Corporate DirectorRegional Nurse Consultant Jan 22, 2024 33%
Operational/Managerial ControlRegional Nurse Consultant Jan 22, 2024 33%
James N Estes Jr Family Dynasty TR No 2 Organization, Tuscaloosa, AL 5% Or Greater Indirect Ownership Interest Mar 29, 2013 18.25%
Jeanne Marie Freeman Individual W-2 Managing EmployeeAdministrator Oct 2, 2023 100%
Operational/Managerial ControlAdministrator Oct 2, 2023 100%
Brandon S. Agee Individual Other Jan 1, 2022 49%
NHS Management, LLC Organization, Tuscaloosa, AL LLC, For-profit Other Jul 1, 2013
Palm Gardens Health Realty LLC Organization, Tuscaloosa, AL LLC, For-profit 5% Or Greater Security Interest Jul 1, 2013
Capital Funding LLC Organization, Baltimore, MD LLC, Financial institution, For-profit 5% Or Greater Mortgage Interest Jul 1, 2013
5% Or Greater Security Interest Jul 1, 2013
Servisfirst Bank Organization, Birmingham, AL Corporation, Financial institution, For-profit 5% Or Greater Security Interest Aug 29, 2018

Facilities with the same owner 42

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 42

Practitioners & affiliated clinicians

Practitioners 2

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": "1370563200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1603843200000",
    "number": "1972941391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3104 DAUPHIN SQ CONNECTOR",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366072513",
            "telephone_number": "251-450-2800",
            "fax_number": "251-450-2802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3104 DAUPHIN SQ CONNECTOR",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366072513",
            "telephone_number": "251-450-2800",
            "fax_number": "251-450-2802"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PALM GARDENS HEALTH AND REHABILITATION, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-06-07",
        "last_updated": "2020-10-28",
        "certification_date": "2020-10-28",
        "status": "A",
        "authorized_official_last_name": "LONG",
        "authorized_official_first_name": "PHILLIP",
        "authorized_official_middle_name": "CODY",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "205-391-3600"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "152549",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mobile, AL

Sources for this page

Verify at the official NPI Registry.