1. Home
  2. Directory
  3. Georgia
  4. Mc Rae
  5. Skilled Nursing Facility
  6. NPI Profile

MCRAE MANOR NURSING HOME
NPI 1033123682
Skilled Nursing Facility in Mc Rae, GA

Active since July 28, 2006CLIA 11D0672526 · Waiver
160 S FIRST AVE, MC RAE, GA 31055(229) 868-6473(229) 868-2981 Get Directions Write a Review

NPPES record last updated: May 19, 2013. Verified against the NPPES registry weekly; last sync: August 23, 2026.

About Mcrae Manor Nursing Home NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MCRAE MANOR NURSING HOME (NPI 1033123682) is a healthcare organization registered as a skilled nursing facility in Mc Rae, Georgia and active in the NPI registry since July 2006. The organization holds a CLIA Waiver certificate valid through August 31, 2026 and lists Terrell Buford Cook, Coo, as its authorized official.

NPPES Registry Identity

NPI1033123682
Entity TypeOrganization
Primary Taxonomy314000000X
Legal Business NamePINE LEAF INVESTMENT INC.
Location Address160 S FIRST AVEMc Rae, GA 31055-3334
Mailing AddressPo Box 179Mc Rae, GA 31055-0179 · (229) 868-6473 · Fax (229) 868-2981
Phone(229) 868-6473
Fax(229) 868-2981
Organization SubpartNo
Authorized OfficialTerrell Buford CookCoo · (229) 868-7406
Enumeration DateJuly 28, 2006
Last NPPES UpdateMay 19, 2013
✔ NPI 1033123682 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySkilled Nursing FacilityNursing & Custodial Care Facilities
Taxonomy Code314000000X
License✔ Licensed in GA · 1-134-1797
Definition
(1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis.
160 S FIRST AVE, Mc Rae, GA 31055
Open in Google Maps ↗

Other Names 1

Doing Business AsMcrae Manor Nursing Home

Other Identifiers 2

Medicare OSCAR/certification115494GA
Medicaid000141853AGA

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 11D0672526

Phg Mcrae LLC Dba Mcrae Manor Nursing Home · Mcrae, GA
Active · expires Aug 31, 2026
CLIA Number11D0672526
Laboratory TypeSkilled Nursing Facility/Nursing Facility
Certificate Effective DateSeptember 1, 2024
Certificate Expiration DateAugust 31, 2026
Laboratory DirectorBrian D. Sidall
Laboratory Phone(229) 868-6473
Laboratory LocationPhg Mcrae LLC Dba Mcrae Manor Nursing Home160 S First Avenue, Mcrae, GA 31055
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

PHG MCRAE LLC
Skilled Nursing Facility
160 S FIRST AVE
MC RAE, GA 31055
Telfair County (229) 868-6473

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Pine Leaf Investment Inc.'s NPI number?

The NPI number for Pine Leaf Investment Inc. is 1033123682. It was assigned to this organization in the NPPES registry on July 28, 2006. The provider is doing business as Mcrae Manor Nursing Home.

Where is Pine Leaf Investment Inc. located?

Pine Leaf Investment Inc. is located at 160 S First Ave, Mc Rae, GA 31055. The listed phone number is (229) 868-6473.

What is Pine Leaf Investment Inc.'s specialty?

The primary specialty registered for this NPI is Skilled Nursing Facility with taxonomy code 314000000X.

Does Pine Leaf Investment Inc. hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 11D0672526) is associated with this NPI, valid through August 31, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Pine Leaf Investment Inc. was last updated on May 19, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.