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Shady Grove Rest Home Inc

Skilled Nursing Facility in Kennesaw, GA · enumerated 2006 · authorized official James Ross, Administrator.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1538228648

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Registry record

Entity type Organization (Type 2)
Legal business name Shady Grove Rest Home Inc
Other name <Unavail>
Practice address 1780 Old 41 Hwy Nw, Kennesaw, GA, 30152
Phone (770) 427-7256
Fax (770) 514-6831
Enumeration date Dec 6, 2006
Last updated in NPPES Aug 22, 2020

Taxonomy & classification

314000000X Skilled Nursing Facility Nursing & Custodial Care Facilities · License 10331268 (GA) Primary

Authorized official

Name James Ross
Title Administrator
Phone (770) 427-7256

Other identifiers

Identifier Type State Issuer
4645261 Other GA AETNA INSURANCE CO
00142942A Medicaid GA -
7100156 Other GA EVERCARE UNITED HEALTHCAR

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

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Frequently asked questions

What is the NPI number for Shady Grove Rest Home Inc?
The NPI for Shady Grove Rest Home Inc is 1538228648, a Type 2 (organization) record in the CMS NPPES registry.
Who is the authorized official for Shady Grove Rest Home Inc?
NPPES lists James Ross (Administrator) as the authorized official for this organization.

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Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2020-08-22.