PRUITTHEALTH - CREEKSIDE, LLC
NPI 1104536077
Skilled Nursing Facility in Augusta, GA

NPI Status: Active since December 01, 2022

Contact Information

2021 SCOTT RD
AUGUSTA, GA
ZIP 30906
Phone: (770) 279-6200

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  • Organization
  • Skilled Nursing Facility
  • Accepts Insurance
  • CLIA Number: 11D2271213
  • CLIA Cert. Type: Skilled Nursing Facility/Nursing Facility
  • CLIA Exp. Date: 10-30-2026

About PRUITTHEALTH - CREEKSIDE, LLC

This page provides the complete NPI Profile along with additional information for Pruitthealth - Creekside, Llc, a provider established in Augusta, Georgia operating as a Skilled Nursing Facility. The healthcare provider is registered in the NPI registry with number 1104536077 assigned on December 2022. The practitioner's primary taxonomy code is 314000000X. The provider is registered as an organization and their NPI record was last updated 4 years ago. The authorized official of this NPI record is Neil L Pruitt Jr. (Chairman And Ceo)

NPI
1104536077
Provider Name
PRUITTHEALTH - CREEKSIDE, LLC
Entity Type
Organization
Location Address
2021 SCOTT RD AUGUSTA, GA 30906
Location Phone
(770) 279-6200
Mailing Address
1626 JEURGENS CT ATTN: LEGAL DEPT NORCROSS, GA 30093
Mailing Phone
(770) 279-6200
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
12-01-2022
Last Update Date
12-01-2022
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Skilled Nursing Facility

Taxonomy Code
314000000X
Type
Nursing & Custodial Care Facilities
Taxonomy Description
(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.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • SoloCare Bronze EPO $8500 DED HSA 10004 - EPO
  • SoloCare Exp Bronze EPO $9500 DED 10015 - EPO
  • SoloCare Gold EPO $1500 DED 10010 - EPO
  • SoloCare Silver EPO $5000 DED 10014 - EPO
  • SoloCare Silver EPO $6500 DED 10013 - EPO
  • SoloCare Standard Exp Bronze EPO $7500 DED 10008 - EPO
  • SoloCare Standard Gold EPO $2000 DED 10006 - EPO
  • SoloCare Standard Platinum EPO $0 DED 10005 - EPO
  • SoloCare Standard Silver EPO $6000 DED 10007 - EPO
  • Elite Bronze - HMO
  • Elite Bronze + Vision + Adult Dental - HMO
  • Everyday Bronze - HMO
  • Everyday Bronze + Vision + Adult Dental - HMO
  • Focused Silver - HMO
  • Standard Expanded Bronze - HMO
  • Standard Gold - HMO
  • Standard Silver - HMO
  • Standard Silver + Vision + Adult Dental - HMO
  • Clarity Silver - HMO
  • Complete Gold - HMO
  • Complete Gold + Vision + Adult Dental - HMO
  • Elite Bronze - HMO
  • Elite Bronze + Vision + Adult Dental - HMO
  • Enhanced Diabetes Care Silver with $0 Drug Options - HMO
  • Enhanced Diabetes Care Silver with $0 Drug Options + Vision + Adult Dental - HMO
  • Everyday Bronze - HMO
  • Everyday Bronze + Vision + Adult Dental - HMO
  • Everyday Gold - HMO
  • Complete Gold - EPO
  • Complete Gold + Vision + Adult Dental - EPO
  • Elite Bronze - EPO
  • Elite Bronze + Vision + Adult Dental - EPO
  • Elite Gold - EPO
  • Elite Gold + Vision + Adult Dental - EPO
  • Enhanced Diabetes Care Silver with $0 Drug Options - EPO
  • Enhanced Diabetes Care Silver with $0 Drug Options + Vision + Adult Dental - EPO
  • Everyday Bronze - EPO
  • Everyday Bronze + Vision + Adult Dental - EPO
  • Clear Silver with $0 Insulin Options - HMO
  • Complete Gold - HMO
  • Complete Gold + Vision + Adult Dental - HMO
  • Complete Gold with Atrium Health - HMO
  • Complete Gold with Atrium Health + Vision + Adult Dental - HMO
  • Elite Bronze - HMO
  • Elite Bronze + Vision + Adult Dental - HMO
  • Elite Bronze with Atrium Health - HMO
  • Elite Bronze with Atrium Health + Vision + Adult Dental - HMO
  • Enhanced Asthma/COPD Care Silver with $0 Drug Options - HMO
  • Elite Bronze - EPO
  • Elite Bronze + Vision + Adult Dental - EPO
  • Elite Gold - EPO
  • Elite Gold + Vision + Adult Dental - EPO
  • Enhanced Diabetes Care Silver with $0 Drug Options - EPO
  • Enhanced Diabetes Care Silver with $0 Drug Options + Vision + Adult Dental - EPO
  • Everyday Bronze - EPO
  • Everyday Bronze + Vision + Adult Dental - EPO
  • Everyday Gold - EPO
  • Everyday Gold + Vision + Adult Dental - EPO
  • UHC Bronze Copay Focus $0 Indiv Med Ded - HMO
  • UHC Bronze Copay Focus+ $0 Indiv Med Ded (Dental + Vision) - HMO
  • UHC Bronze Essential - HMO
  • UHC Bronze Essential- - HMO
  • UHC Bronze Standard - HMO
  • UHC Bronze Standard Plus Chiro - HMO
  • UHC Gold Advantage - HMO
  • UHC Gold Advantage+ (Dental + Vision) - HMO
  • UHC Gold Copay Focus $0 Indiv Med Ded - HMO
  • UHC Gold Standard - HMO

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

NEIL L PRUITT JR.

Authorized Official Title
CHAIRMAN AND CEO
Authorized Official Phone
(770) 279-6200

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
11D2271213
Facility Type
Skilled Nursing Facility/Nursing Facility
Certificate Effective Date
October 31, 2024
Certificate Expiration Date
October 30, 2026
Laboratory Director
JESSICA LOVE
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Pruitthealth - Creekside, Llc to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

Reviews for PRUITTHEALTH - CREEKSIDE, LLC

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1104536077, we treat the final digit (7) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 43. The final step is to find the difference between that total and the next multiple of ten (50 - 43 = 7).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
1
Unchanged
Pos 3
0
Doubled → 0
Pos 4
4
Unchanged
Pos 5
5
Doubled → 10 → 1 + 0
Pos 6
3
Unchanged
Pos 7
6
Doubled → 12 → 1 + 2
Pos 8
0
Unchanged
Pos 9
7
Doubled → 14 → 1 + 4
Check
7
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 0 → 0 5 → 10 → 1 6 → 12 → 3 7 → 14 → 5

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 1 + 0 + 4 + 1 + 0 + 3 + 1 + 2 + 0 + 1 + 4 + 24 = 43

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 43 is 50. The difference is the calculated check digit.

50 - 43 = 7
This NPI is valid
The calculated check digit is 7, which matches the last digit of 1104536077.

Other Providers at the Same Location


The following 4 providers are registered at the same or a nearby location.

Skilled Nursing Facility
2021 SCOTT RD
AUGUSTA, GA 30906
Audiologist
2021 SCOTT RD
AUGUSTA, GA 30906
Skilled Nursing Facility
2021 SCOTT RD
AUGUSTA, GA 30906
Physical Therapy Assistant
2021 SCOTT RD
AUGUSTA, GA 30906

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1104536077, enumerated as an "organization" on December 01, 2022.

The provider is located at 2021 SCOTT RD AUGUSTA, GA 30906 and the phone number is (770) 279-6200.

Skilled Nursing Facility with taxonomy code 314000000X.

The provider might be accepting Accepts: Alliant Health Plans, Inc., Ambetter from Absolute. Please consult your insurance carrier or call the provider to verify.