Blue Ridge SNF Operations LLC
Organization Active NPI Skilled Nursing Facility · Stuart, VA
NPI 1013478411 · NPPES record last updated Mar 28, 2019
Key facts
- NPI
- 1013478411
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Skilled Nursing Facility 314000000X
- Legal business name
- BLUE RIDGE SNF OPERATIONS LLC
- Practice address
- 105 Landmark Dr
Stuart, VA 24171-9401 - Phone
- (276) 694-4230
- NPI assigned
- Mar 28, 2019
- Organization subpart
- No
Authorized official
- Name
- Shimmy Idels
- Title
- Coo
- Phone
- (917) 565-7391
Facilities with the same owner 47
Practitioners 1
-
Richard Claude Cole, M.D.
Affiliated clinicians 1
-
Richard Claude Cole, M.D.
Medicare Care Compare: Nursing home
- Listed as
- Blue Ridge Therapy Connection
- Overall star rating
- ★★★★☆ 4 of 5
- Health inspections
- ★★★★☆ 4 of 5
- Staffing
- ★★☆☆☆ 2 of 5
- Quality measures
- ★★★☆☆ 3 of 5
- Type
- Medicare and Medicaid
- Ownership
- For profit - Limited Liability company
- Certified
- Jan 1, 1996
- Medicare certification status
- Active
- Certified beds
- 190 · 157.8 residents per day on average
- Chain
- Hill Valley Healthcare
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 49D0232064 | Blue Ridge SNF Operations LLC | Certificate of waiver | Aug 31, 2026 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in VA
Skilled nursing facility certification: CCN 495306
- Legal name
- BLUE RIDGE SNF OPERATIONS LLC
- Doing business as
- BLUE RIDGE THERAPY CONNECTION
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Jan 1, 1996
- Last certification
- Feb 29, 2024
- Beds
- 190
- Ownership / control type
- Limited Liability Corporation
- Organization structure
- LLC · Proprietary
- Incorporated
- in VA
- Enrollment address
- 105 Landmark Dr
Stuart, VA 24171-9401 - Nursing home name
- BLUE RIDGE THERAPY CONNECTION
- Affiliated entity
- HILL VALLEY HEALTHCARE
All disclosed owners & managing parties 12
| Name | Role | Since | Share |
|---|---|---|---|
| Sabrina 1818 Holdings LLC |
5% Or Greater Indirect Ownership Interest | Jul 1, 2019 | 46.2% |
| Saessy Irrevocable Trust |
5% Or Greater Indirect Ownership Interest | Jul 1, 2019 | 45.2% |
| Michael Greeley |
W-2 Managing Employee |
Jul 1, 2019 | |
| Joseph E Lieberman |
Corporate Officer | Jul 1, 2019 | 47.5% |
| Steven a Schwartz |
Corporate Officer |
Jul 1, 2019 | 47.5% |
| Shimon Idels |
Corporate Officer |
Jul 1, 2019 | 5% |
| Landmark Operations Holdings LLC |
5% Or Greater Direct Ownership Interest | Jul 1, 2019 | 100% |
| HVH Landmark Management LLC |
Operational/Managerial Control | Jul 1, 2019 | 100% |
| Delilah 2626 Holdings LLC |
5% Or Greater Indirect Ownership Interest | Jul 1, 2019 | 5% |
| VNB New York LLC |
5% Or Greater Security Interest | Jul 1, 2019 | |
| Tatiriq Irrevocable Trust |
5% Or Greater Indirect Ownership Interest | Jul 1, 2019 | 43.9% |
| Lion 26 Holdings LLC |
5% Or Greater Indirect Ownership Interest | Jul 1, 2019 | 47.5% |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20190904002498 | VA | Part a Provider - Skilled Nursing Facility | 7012246861 | Practice locations: Stuart, VA |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | Yes |
Addresses
Primary practice location
105 Landmark Dr
Stuart, VA 24171-9401
Mailing address
7523 Main St # 39
Flushing, NY 11367-7652
Other names
- Blue Ridge Therapy Connection
Other providers in Stuart, VA
- Bette G Bell
- Jim Best Jr.
- Crystal Black
- Blue Ridge Counseling Services, LLC
- Blue Ridge Nursing Center, Inc.
- Emily Elizabeth Bowman
- Breaking Chains
- Daniel Brown
- Mitchell Brown
- Gail Powers Browning
All providers in Stuart, VA · Skilled Nursing Facility in Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 28, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.