NPIMap

Organization Active NPI

Jonesboro Nursing and Rehabilitation Center, LLC

  • Skilled Nursing Facility
  • Jonesboro, GA
National Provider Identifier
1992814644
Registry record updated Dec 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
10311772 Issued in GA
Legal business name
JONESBORO NURSING AND REHABILITATION CENTER, LLC
Practice address
2650 Highway 138 E
Jonesboro, GA 30236-2744
Phone
(770) 473-4436
Fax
(770) 473-4698
NPI assigned
Aug 29, 2006
Last updated
Dec 11, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2023

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

Authorized official

Name
Mr. Norbert A Bennett
Title
Co-Ceo
Phone
(716) 662-4955

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 10311772 GA Primary

Addresses

Primary practice location

2650 Highway 138 E
Jonesboro, GA 30236-2744

Mailing address

2650 Highway 138 E
Jonesboro, GA 30236-2744
Phone (770) 473-4436

Other identifiers 1

IdentifierTypeStateIssuer
00531033AMedicaidGA

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL ENDPOINT Other The White Stone Group d/b/a Vyne Medical

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20030612000039 GA Part A Provider - Skilled Nursing Facility 5496665614 Practice locations: Jonesboro, GA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1992814644. Details of each certification follow.

Skilled nursing facility certification: CCN 115545

Legal name
JONESBORO NURSING AND REHABILITATION CENTER, LLC
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
May 4, 1993
Last certification
Mar 27, 2025
Beds
129
Ownership / control type
Limited Liability Corporation
Multi-facility organization
Empire Care Centers
Organization structure
LLCProprietary
Incorporated
May 7, 2003 in GA
Enrollment address
2650 Highway 138 E
Jonesboro, GA 30236-2744

Care Compare: Nursing home

Medicare Care Compare
Listed as
Jonesboro Center for Nursing and Healing LLCCCN 115545 · All quality measures
Overall star rating
1 of 5
Health inspections
2 of 5
Staffing
1 of 5
Quality measures
2 of 5
Type
Medicare and Medicaid
Ownership
For profit - Limited Liability company
Certified
May 4, 1993
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
129118.6 residents per day on average
Penalties (3 years)
4Fines totaling $16,801

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 9

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

NameRoleSinceShare
Donad T Denz Irrv TR Organization, Buffalo, NY 5% Or Greater Indirect Ownership Interest May 23, 2008 6%
Norbert a Bennett Individual 5% Or Greater Indirect Ownership Interest Jun 30, 2003 32.45%
Donald T Denz Individual 5% Or Greater Indirect Ownership Interest Jun 30, 2003 44%
Norbert a Bennett Irrv TR Fbo Grandchildren Organization, Holland, NY 5% Or Greater Indirect Ownership Interest May 23, 2008 17.55%
Norbert a Bennett Irrv TR Fbo Children Organization, Holland, NY 5% Or Greater Indirect Ownership Interest May 23, 2008 17.55%
Renee Klawon Individual OtherIndependent Contractor Aug 14, 2020
D&N, LLC Organization, Orcahrd Park, NY Created for acquisition, LLC 5% Or Greater Direct Ownership Interest Jun 30, 2003 50%
DTD HC LLC Organization, Orchard Park, NY Created for acquisition, LLC 5% Or Greater Direct Ownership Interest Jun 30, 2003 50%
Marcus Oates Individual W-2 Managing EmployeeExecutive Director Apr 5, 2021 100%

Facilities with the same owner 30

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

View all 30

Practitioners & affiliated clinicians

Practitioners 3

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.

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": "1156809600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1702252800000",
    "number": "1992814644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2650 HIGHWAY 138 E",
            "city": "JONESBORO",
            "state": "GA",
            "postal_code": "302362744",
            "telephone_number": "770-473-4436",
            "fax_number": "770-473-4698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2650 HIGHWAY 138 E",
            "city": "JONESBORO",
            "state": "GA",
            "postal_code": "302362744",
            "telephone_number": "770-473-4436",
            "fax_number": "770-473-4698"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JONESBORO NURSING AND REHABILITATION CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-29",
        "last_updated": "2023-12-11",
        "certification_date": "2023-12-11",
        "status": "A",
        "authorized_official_last_name": "BENNETT",
        "authorized_official_first_name": "NORBERT",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CO-CEO",
        "authorized_official_telephone_number": "716-662-4955",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "GA",
            "license": "10311772",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00531033A",
            "state": "GA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "ENDPOINT",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.17.8788.1",
            "affiliationName": "The White Stone Group d/b/a Vyne Medical",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "100 Ashford Ctr N Ste 300",
            "city": "Atlanta",
            "state": "GA",
            "country_code": "US",
            "postal_code": "303384863",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Jonesboro, GA

Sources for this page

Verify at the official NPI Registry.