NPIMap

Organization Active NPI

Pruitthealth Hospice, Inc.

Doing business as PruittHealth Hospice - Eastern Carolina

  • Community Based Hospice Care Agency
  • Greenville, NC
National Provider Identifier
1992744361
Registry record updated Jun 21, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
Legal business name
PRUITTHEALTH HOSPICE, INC.
Doing business as
PruittHealth Hospice - Eastern Carolina
Practice address
2313 Executive Cir Ste a
Greenville, NC 27834
Phone
(252) 753-7741
NPI assigned
Jun 4, 2006
Last updated
Jun 21, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2018

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

Authorized official

Name
Mr. Neil L Pruitt Jr.
Title
Chairman and Ceo
Phone
(770) 279-6200

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X Primary

Addresses

Primary practice location

2313 Executive Cir Ste a
Greenville, NC 27834

Mailing address

1626 Jeurgens CT
Norcross, GA 30093-2219
Phone (770) 279-6200

Other practice location 1

3409 RL Davis Lane
Farmville, NC 27828-8517
Phone (252) 753-7741

Other identifiers 1

IdentifierTypeStateIssuer
3401591MedicaidNC

Other names 1

  • PruittHealth Hospice - Eastern Carolina Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20051109000318 NC Part A Provider - Hospice 2264344217 4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Rocky Mount, NC; North Wilkesboro, NC; New Bern, NC; Fayetteville, NC; Greenville, NC
O20220810003250 NC Part B Supplier - Clinic/Group Practice 2264344217 Receives reassigned benefits from 13 practitioners
4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Rocky Mount, NC; North Wilkesboro, NC; New Bern, NC; Greenville, NC; Fayetteville, NC

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1992744361. Details of each certification follow.

Hospice certification: CCN 341591

Legal name
PRUITTHEALTH HOSPICE INC
Doing business as
PRUITTHEALTH HOSPICE - ROCKY MOUNT
Certification status
Active
Provider type (POS)
Hospice
Participating since
Jan 10, 2006
Last certification
Feb 20, 2020
Ownership / control type
Proprietary - Individual
Organization structure
CorporationProprietary
Incorporated
Oct 14, 1993 in GA
Enrollment address
301 S Church St
Ste 135
Rocky Mount, NC 27804-5721

Other NPIs on the same Medicare enrollment 5

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Care Compare: Hospice

Medicare Care Compare
Listed as
Pruitthealth Hospice - Rocky MountCCN 341591 · All quality measures
Ownership
For-Profit
Certified
Jan 10, 2006
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory
Tax ID family
Pruitthealth Hospice Inc26 organizations share this tax ID, including this one

Other organizations with this tax ID 25

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

View all 25

Locations (25 of 27)

435 Hawthorne Ave
Ste 200
Athens, GA 30606
Phone (706) 552-1699

1220 Augusta West Pkwy
Augusta, GA 30909
Phone (678) 533-6485

2604 Commons Blvd
Augusta, GA 30909
Phone (706) 733-6900

1674 Mulkey Rd
Ste 103
Austell, GA 30106
Phone (770) 916-4503

1676 Mulkey Rd
Ste 103
Austell, GA 30106
Phone (770) 916-4503

5004 Appalachian Hwy
Ste 3A
Blue Ridge, GA 30513
Phone (706) 632-0027

150 Warrior Path NE
Ste 2
Calhoun, GA 30701
Phone (706) 602-9546

197 Curtis Pkwy NE
Calhoun, GA 30701
Phone (706) 463-6132

620 Ponder Place Dr
Ste 1A
Evans, GA 30809
Phone (706) 650-1552

2484 Ingleside Ave
Bldg B
Macon, GA 31204
Phone (478) 745-9204

6060 Lakeside Commons Dr
Macon, GA 31210
Phone (478) 745-9204

770 Greison Trl
Ste B
Newnan, GA 30263
Phone (770) 254-8573

772 Greison Trl
Ste F
Newnan, GA 30263
Phone (770) 254-8612

5365 Oakbrook Pkwy
Norcross, GA 30093

315 W 10th St NE
Ste C
Rome, GA 30165
Phone (706) 219-4799

7345 Red Oak Rd
Bldg 25
Union City, GA 30291
Phone (770) 254-8573

3723 West Wilson St
Farmville, NC 27828
Phone (252) 753-7741

2313 Executive Cir
Ste A
Greenville, NC 27834
Phone (252) 751-7741

1310 Helen Ave
New Bern, NC 28560
Phone (252) 633-4311

924 Main St
Ste 100
North Wilkesboro, NC 28659
Phone (336) 667-0548

1 Poston Rd
#238B
Charleston, SC 29407
Phone (843) 573-8623

1 Poston Rd
Ste 238
Charleston, SC 29407
Phone (843) 573-8623

171 Church St
Ste 210
Charleston, SC 29401
Phone (843) 573-8623

2541 Forest Dr
Columbia, SC 29204
Phone (803) 254-5960

301 Halton Rd
Ste B
Greenville, SC 29607
Phone (864) 962-6699

Ownership & related parties

All disclosed owners & managing parties 13

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

NameRoleSinceShare
Amy D Taylor Individual W-2 Managing EmployeeAdmnistrator Oct 27, 2013
United Health Services Inc Organization, Norcross, GA For-profit 5% Or Greater Indirect Ownership Interest Jan 2, 2006 100%
Philip W. Small Individual Corporate DirectorDir Sep 17, 2013
Pruitthealth Inc Organization, Norcross, GA Non-profit 5% Or Greater Direct Ownership Interest Jan 1, 2022
Operational/Managerial Control Jan 7, 2008
Melissa D Whealton Individual W-2 Managing Employee Jan 13, 2015
Lisa P Hamby Trust Organization, Norcross, GA 5% Or Greater Indirect Ownership Interest Jan 2, 2006 31.65%
Neil Little Pruitt Individual Corporate Officer Jan 2, 2006
Corporate Director Nov 9, 2005
OtherCho Admin Jan 2, 2006
Neil L Pruitt Jr Trust Organization, Norcross, GA 5% Or Greater Indirect Ownership Interest Jan 2, 2006 35.93%
Nancy W Pruitt Individual Corporate OfficerSec Jan 2, 2006
Uhs-Pruitt Holdings, Inc. Organization, Norcross, GA For-profit 5% Or Greater Indirect Ownership Interest Jan 2, 2006 100%
Thomas R Beddingfield Individual Corporate DirectorDir Sep 17, 2013
United Health Services of Georgia, Inc. Organization, Norcross, GA For-profit 5% Or Greater Direct Ownership Interest Jan 2, 2006 99%
J Paige Pruitt Trust Organization, Norcross, GA 5% Or Greater Indirect Ownership Interest Jan 2, 2006 31.32%

Practitioners & affiliated clinicians

Practitioners 71

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.

View all 71

Affiliated clinicians 18

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

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1149379200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529539200000",
    "number": "1992744361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1626 JEURGENS CT",
            "city": "NORCROSS",
            "state": "GA",
            "postal_code": "300932219",
            "telephone_number": "770-279-6200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2313 EXECUTIVE CIR STE A",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "27834",
            "telephone_number": "252-753-7741"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3409 RL Davis Lane",
            "address_purpose": "LOCATION",
            "city": "Farmville",
            "state": "NC",
            "postal_code": "278288517",
            "country_code": "US",
            "telephone_number": "252-753-7741",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PRUITTHEALTH HOSPICE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-04",
        "last_updated": "2018-06-21",
        "status": "A",
        "authorized_official_last_name": "PRUITT",
        "authorized_official_first_name": "NEIL",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CHAIRMAN AND CEO",
        "authorized_official_telephone_number": "770-279-6200",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3401591",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PruittHealth Hospice - Eastern Carolina",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Greenville, NC

Sources for this page

Verify at the official NPI Registry.