PROVIDENCE SNF OPERATOR LLC
NPI 1114448271
Skilled Nursing Facility in Thomaston, GA

Active since June 29, 2017CLIA 11D2165830 · Waiver
1/5
Overall Rating
1011 S GREEN ST, THOMASTON, GA 30286(706) 647-6693(706) 648-9255 Get Directions Write a Review

NPPES record last updated: July 21, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jul 21, 2022, Jun 29, 2017 (2 updates tracked since 2017).

About Providence Snf Operator Llc NPPES

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

PROVIDENCE SNF OPERATOR LLC (NPI 1114448271) is a healthcare organization registered as a skilled nursing facility in Thomaston, Georgia and active in the NPI registry since June 2017. The organization holds a CLIA Waiver certificate valid through May 6, 2027 and lists Bruce E Wertheim, Manager, as its authorized official.

NPPES Registry Identity

NPI1114448271
Entity TypeOrganization
Primary Taxonomy314000000X
Legal Business NamePROVIDENCE SNF OPERATOR LLC
Location Address1011 S GREEN STThomaston, GA 30286-4643
Mailing Address1011 S Green StThomaston, GA 30286-4643 · (706) 647-6693 · Fax (706) 648-9255
Fax(706) 648-9255
Organization SubpartNo
Authorized OfficialBruce E WertheimManager · (813) 347-9888
Enumeration DateJune 29, 2017
Last NPPES UpdateJuly 21, 20222 updates tracked since enumeration
NPI 1114448271 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtySkilled Nursing FacilityNursing & Custodial Care Facilities
Taxonomy Code314000000X
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.
1011 S GREEN ST, Thomaston, GA 30286

Accepted Insurance

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 11D2165830

Providence Snf Operator, LLC Dba Providence Healthcare · Thomaston, GA
Active · expires May 6, 2027
CLIA Number11D2165830
Laboratory TypeSkilled Nursing Facility/Nursing Facility
Certificate Effective DateMay 7, 2025
Certificate Expiration DateMay 6, 2027
Laboratory DirectorJonathan F. Busbee
Laboratory Phone(706) 647-6693
Laboratory LocationProvidence Snf Operator, LLC Dba Providence Healthcare1011 South Green Street, Thomaston, GA 30286
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Nursing Home Quality Ratings CMS Care Compare

Quality ratings, staffing and inspection history for Providence Healthcare (CMS certification number 115484), from CMS Care Compare.

Providence Healthcare

Nursing home · Thomaston, GA
1/5 CMS Overall Rating
OwnershipFor profit - Limited Liability company
CMS Certification Number115484
Certified Beds110 beds68 residents per day on average
Medicare & Medicaid Participant SinceOctober 1, 1989
Resident & Family CouncilResident council
Automatic sprinkler system

CMS Star Ratings

Quality Measures
Based on a select set of clinical quality measures.
3/5
Long-Stay Quality
Quality of care delivered to long-term residents.
3/5
Short-Stay Quality
Quality of care delivered to short-term and rehabilitation residents.
2/5
Staffing
Based on nursing staff hours relative to resident needs.
1/5
Weighted Health Inspection Score
Lower scores are better; the score summarizes deficiencies found on recent inspections.
186.67
Ratings are assigned by CMS on a one-to-five star scale; five is the highest. Categories without a current CMS rating are not shown.

Staffing & Turnover

Total Nurse Staffing
nurse aide 1.5 · LPN 0.92 · RN 0.24
2.67 hrs per resident per day
Weekend Nurse Staffing
2.38 hrs per resident per day
Physical Therapist Staffing
0 hrs per resident per day
Nursing Staff Turnover
Share of nursing staff who left the facility within the past year.
60.8%
Registered Nurse Turnover
71.4%
Administrators Who Have Left
In the past year.
2
Higher staffing hours generally allow more direct care time per resident.

Inspections & Enforcement

Facility-Reported Incidents
0
Substantiated Complaints
4
Infection-Control Citations
11
Fines
14 totaling $363,372.47
Medicare Payment Denials
0
Total Penalties
14
Counts come from CMS inspections and complaint investigations over approximately the past three years. CMS Care Compare data as of October 1, 2024.

Other Providers at the Same Location NPPES 3

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

Skilled Nursing Facility
1011 S GREEN ST
THOMASTON, GA 30286
Skilled Nursing Facility
1011 S GREEN ST
THOMASTON, GA 30286
Skilled Nursing Facility
1011 S GREEN ST
THOMASTON, GA 30286

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 Providence Snf Operator LLC's NPI number?

The NPI number for Providence Snf Operator LLC is 1114448271. It was assigned to this organization in the NPPES registry on June 29, 2017.

Where is Providence Snf Operator LLC located?

Providence Snf Operator LLC is located at 1011 S Green St, Thomaston, GA 30286. The listed phone number is (706) 647-6693.

What is Providence Snf Operator LLC's specialty?

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

Does Providence Snf Operator LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 11D2165830) is associated with this NPI, valid through May 6, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

Is Providence Snf Operator LLC a Medicare-certified nursing home?

Yes. Providence Healthcare is a Medicare-certified nursing home with 110 certified beds.

What quality rating does Providence Snf Operator LLC have?

CMS rates Providence Healthcare 1 out of 5 stars overall on Care Compare. The full measure detail is in the Nursing Home Quality Ratings section above.

What insurance does Providence Snf Operator LLC accept?

Health plans from Mending Health list Providence Snf Operator LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Providence Snf Operator LLC was last updated on July 21, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.