PRUITTHEALTH - CRESTWOOD
NPI 1295774222
Skilled Nursing Facility in Valdosta, GA

Active since June 05, 2006
415 PENDLETON PL, VALDOSTA, GA 31602(229) 242-6868(229) 242-5357 Get Directions Write a Review

NPPES record last updated: May 9, 2014. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Pruitthealth - Crestwood NPPES

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

PRUITTHEALTH - CRESTWOOD (NPI 1295774222) is a healthcare organization registered as a skilled nursing facility in Valdosta, Georgia and active in the NPI registry since June 2006. The organization lists Neil L Pruitt, Chairman And Ceo Of Manager, as its authorized official.

NPPES Registry Identity

NPI1295774222
Entity TypeOrganization
Primary Taxonomy314000000X
Legal Business NameLOWNDES COUNTY HEALTH SERVICES LLC
Location Address415 PENDLETON PLValdosta, GA 31602-2632
Mailing Address1626 Jeurgens CtNorcross, GA 30093-2219 · (770) 279-6200 · Fax (770) 931-5278
Fax(229) 242-5357
Organization SubpartNo
Authorized OfficialNeil L PruittChairman And Ceo Of Manager · (770) 279-6200
Enumeration DateJune 5, 2006
Last NPPES UpdateMay 9, 2014
NPI 1295774222 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 · 1-092-936
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.

415 PENDLETON PL, Valdosta, GA 31602

Other Names 1

Doing Business AsPruitthealth - Crestwood

Other Identifiers 2

Medicaid00140764AGA
Medicare OSCAR/certification115385GA

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 Compliance 11D0674486

Lowndes County Health Department · Valdosta, GA
Active · expires Mar 19, 2027
CLIA Number11D0674486
Laboratory TypeCommunity Clinic
Certificate Effective DateMarch 20, 2025
Certificate Expiration DateMarch 19, 2027
Laboratory DirectorMark J. Eanes
Laboratory Phone(229) 333-5259
Laboratory LocationLowndes County Health Department206 South Patterson Street, Valdosta, GA 31601
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

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.

Clinic/Center (Rehabilitation)
415 PENDLETON PL
VALDOSTA, GA 31602
Skilled Nursing Facility
415 PENDLETON PL
VALDOSTA, GA 31602
Registered Nurse (Gerontology)
415 PENDLETON PL
VALDOSTA, GA 31602

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1295774222, enumerated as an "organization" on June 05, 2006.

The provider is located at 415 PENDLETON PL VALDOSTA, GA 31602 and the phone number is (229) 242-6868.

Skilled Nursing Facility with taxonomy code 314000000X.

The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.