TATTNALL HEALTH CARE
NPI 1063454718
Skilled Nursing Facility in Reidsville, GA

Active since June 10, 2006CLIA 11D0698313 · Waiver
142 MEMORIAL DR, REIDSVILLE, GA 30453(912) 557-4345(912) 557-3019 Get Directions Write a Review

NPPES record last updated: September 29, 2008. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Tattnall Health Care NPPES

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

TATTNALL HEALTH CARE (NPI 1063454718) is a healthcare organization registered as a skilled nursing facility in Reidsville, Georgia and active in the NPI registry since June 2006. The organization holds a CLIA Waiver certificate valid through August 31, 2026 and lists Tygh Brogdon, Manager, as its authorized official.

NPPES Registry Identity

NPI1063454718
Entity TypeOrganization
Primary Taxonomy314000000X
Legal Business NameTATTNALL NURSING LLC
Location Address142 MEMORIAL DRReidsville, GA 30453-4652
Mailing Address142 Memorial DrReidsville, GA 30453-4652 · (912) 557-4345 · Fax (912) 557-3019
Fax(912) 557-3019
Organization SubpartNo
Authorized OfficialTygh BrogdonManager · (770) 650-8773
Enumeration DateJune 10, 2006
Last NPPES UpdateSeptember 29, 2008
NPI 1063454718 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 · 1-132-1734
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.

142 MEMORIAL DR, Reidsville, GA 30453

Other Names 1

Doing Business AsTattnall Health Care

Other Identifiers 2

Medicare ID-Type Unspecified11-5575Mutual Of Omaha
Medicaid000143228AGA

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 11D0698313

Tattnall Healthcare Center · Reidsville, GA
Active · expires Aug 31, 2026
CLIA Number11D0698313
Laboratory TypeSkilled Nursing Facility/Nursing Facility
Certificate Effective DateSeptember 1, 2024
Certificate Expiration DateAugust 31, 2026
Laboratory DirectorDelilah Arnold
Laboratory Phone(912) 557-4345
Laboratory LocationTattnall Healthcare Center142 Memorial Drive, Reidsville, GA 30453
CLIA data matches this NPI record on: Address Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 2

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

Skilled Nursing Facility
142 MEMORIAL DR
REIDSVILLE, GA 30453
Skilled Nursing Facility
142 MEMORIAL DR
REIDSVILLE, GA 30453

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 Tattnall Nursing LLC's NPI number?

The NPI number for Tattnall Nursing LLC is 1063454718. It was assigned to this organization in the NPPES registry on June 10, 2006. The provider is doing business as Tattnall Health Care.

Where is Tattnall Nursing LLC located?

Tattnall Nursing LLC is located at 142 Memorial Dr, Reidsville, GA 30453. The listed phone number is (912) 557-4345.

What is Tattnall Nursing LLC's specialty?

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

Does Tattnall Nursing LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 11D0698313) 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 Tattnall Nursing LLC was last updated on September 29, 2008. NPI Profile syncs with the weekly NPPES data releases published by CMS.