OrganizationActive
Coffee County Nursing Home, LLC
NPI 1912036989 · Respite Care · Douglas, GA
Coffee County Nursing Home, LLC is a Respite Care organization in Douglas, GA (NPI 1912036989).
Provider details
- NPI number
- 1912036989
- Entity type
- Organization
- Primary specialty
- Respite CareRespite Care Facility
- Organization subpart
- No
- Authorized official
- Kim Sheffield, Vp of Financial Reporting(478) 621-2100
- License
- 1-056-1784 (GA)
Specialties & taxonomies
Respite Care Facility
Profile Score
Detailed profile(90/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
1310 Gordon St W
Douglas, GA 31533-3432
Phone: (912) 384-7811
Fax: (912) 384-7695
Street-level locationGet directions
Mailing address
1310 Gordon St W
Douglas, GA 31533-3432
Other names (DBA / former)
- Doing business as
- Shady Acres
Registry dates
- Enumerated
- 2007-03-05
- Last updated
- 2020-08-22
Frequently asked questions
- What is Coffee County Nursing Home, LLC's NPI number?
- Coffee County Nursing Home, LLC's National Provider Identifier (NPI) is 1912036989, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Coffee County Nursing Home, LLC?
- Coffee County Nursing Home, LLC is classified in the NPPES registry as Respite Care (Respite Care Facility).
- Where is Coffee County Nursing Home, LLC located?
- Coffee County Nursing Home, LLC's practice location on file with NPPES is 1310 Gordon St W, Douglas, GA 31533-3432.
- What is Coffee County Nursing Home, LLC's phone number?
- The practice phone number listed in the NPPES registry for Coffee County Nursing Home, LLC is (912) 384-7811.
- Who is the authorized official for Coffee County Nursing Home, LLC?
- The authorized official listed on Coffee County Nursing Home, LLC's NPPES record is Kim Sheffield, Vp of Financial Reporting. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Coffee County Nursing Home, LLC's NPI active?
- Yes — Coffee County Nursing Home, LLC's NPI (1912036989) is active in the NPPES registry as of the last update on 2020-08-22.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.