Fayetteville SNF LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

FAYETTEVILLE SNF LLC

Doing business as

Fayetteville Rehabilitation and Healthcare Center

Practice address

100 Hresan Blvd
Fayetteville, WV 25840-1333

Phone

(304) 574-0770

NPI assigned

Jul 21, 2026

Last updated

Jul 21, 2026By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Robert Cohen

Title

Authorized Official

Phone

(347) 463-2399

Specialties & licenses 1

Addresses

Other names 1

• Fayetteville Rehabilitation and Healthcare Center Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1784592000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1784592000000",
    "number": "1043131790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 HRESAN BLVD",
            "city": "FAYETTEVILLE",
            "state": "WV",
            "postal_code": "258401333",
            "telephone_number": "304-574-0770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 HRESAN BLVD",
            "city": "FAYETTEVILLE",
            "state": "WV",
            "postal_code": "258401333",
            "telephone_number": "304-574-0770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAYETTEVILLE SNF LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-07-21",
        "last_updated": "2026-07-21",
        "certification_date": "2026-07-21",
        "status": "A",
        "authorized_official_last_name": "COHEN",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "347-463-2399"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fayetteville Rehabilitation and Healthcare Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Fayette County Board of Education
• Fayette County Board of Health
• Fayette Medical Services PLLC (Fayetteville Urgent Care)
• Fayette Nursing & Rehabilitation Center LLC
• Fayetteville Physical Therapy & Sports Rehabilitation
• Anna Fernandez
• Christy Fernandez
• Five Oaks Family Clinic, Inc.
• Foot and Ankle Clinic of the Virginias Inc
• Brenda Fox

• Skilled Nursing Facility in Fayetteville, WV
• Providers in Fayetteville, WV by specialty
• Skilled Nursing Facility in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.