PRUITTHEALTH - LAKESIDE, LLC
NPI 1427864552
Skilled Nursing Facility in Macon, GA

Active since December 04, 2024CLIA 11D2315894 · Waiver
3020 JEFFERSONVILLE RD, MACON, GA 31217(478) 746-3547 Get Directions Write a Review

NPPES record last updated: December 4, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Pruitthealth - Lakeside, Llc NPPES

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

PRUITTHEALTH - LAKESIDE, LLC (NPI 1427864552) is a healthcare organization registered as a skilled nursing facility in Macon, Georgia and active in the NPI registry since December 2024. The organization holds a CLIA Waiver certificate valid through December 19, 2026 and lists Neil L Pruitt, Chairman And Ceo, as its authorized official.

NPPES Registry Identity

NPI1427864552
Entity TypeOrganization
Primary Taxonomy314000000X
Legal Business NamePRUITTHEALTH - LAKESIDE, LLC
Location Address3020 JEFFERSONVILLE RDMacon, GA 31217-5118
Mailing Address1626 Jeurgens CtNorcross, GA 30093-2219 · (770) 279-6200
Organization SubpartNo
Authorized OfficialNeil L PruittChairman And Ceo · (770) 279-6200
Enumeration DateDecember 4, 2024
NPPES CertifiedDecember 4, 2024
NPI 1427864552 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.
3020 JEFFERSONVILLE RD, Macon, GA 31217

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 11D2315894

Pruitthealth - Lakeside, LLC · Macon, GA
Active · expires Dec 19, 2026
CLIA Number11D2315894
Laboratory TypeSkilled Nursing Facility/Nursing Facility
Certificate Effective DateDecember 20, 2024
Certificate Expiration DateDecember 19, 2026
Laboratory DirectorAndrea Watson
Laboratory Phone(478) 746-3547
Laboratory LocationPruitthealth - Lakeside, LLC3020 Jeffersonville Road, Macon, GA 31217
CLIA data matches this NPI record on: Address Name 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
3020 JEFFERSONVILLE RD
MACON, GA 31217
Nurse Practitioner (Family)
3020 JEFFERSONVILLE RD
MACON, GA 31217

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 Pruitthealth - Lakeside, LLC's NPI number?

The NPI number for Pruitthealth - Lakeside, LLC is 1427864552. It was assigned to this organization in the NPPES registry on December 4, 2024.

Where is Pruitthealth - Lakeside, LLC located?

Pruitthealth - Lakeside, LLC is located at 3020 Jeffersonville Rd, Macon, GA 31217. The listed phone number is (478) 746-3547.

What is Pruitthealth - Lakeside, LLC's specialty?

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

Does Pruitthealth - Lakeside, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 11D2315894) is associated with this NPI, valid through December 19, 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 Pruitthealth - Lakeside, LLC was last updated on December 4, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 20 months 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.