Active NPI
Glenburnie Operator LLC
Doing business as Glenburnie Rehabilitation and Nursing Center
- Skilled Nursing Facility
- Richmond, VA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- Legal business name
- GLENBURNIE OPERATOR LLC
- Doing business as
- Glenburnie Rehabilitation and Nursing Center
- Practice address
- 1901 Libbie Ave
Richmond, VA 23226-1808 - Phone
- (804) 281-3500
- NPI assigned
- Oct 8, 2019
- Last updated
- Jan 9, 2020
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Elazar Fischer
- Title
- Authorized Official
- Phone
- (804) 281-3500
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | Primary |
Addresses
Primary practice location
1901 Libbie Ave
Richmond, VA 23226-1808
Mailing address
1901 Libbie Ave
Richmond, VA 23226-1808
Other names 1
- Glenburnie Rehabilitation and Nursing Center
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in VA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20200528001157 | VA | Part A Provider - Skilled Nursing Facility | 7911335773 | Practice locations: Richmond, VA |
NPI to CCN mapping 1
The Medicare certification numbers (CCNs) connected to NPI 1073154373. Details of each certification follow.
Skilled nursing facility certification: CCN 495391
- Legal name
- GLENBURNIE OPERATOR LLC
- Doing business as
- GLENBURNIE REHABILITATION AND NURSING CENTER
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Mar 27, 2007
- Last certification
- Jan 25, 2024
- Beds
- 125
- Ownership / control type
- Partnership
- Most recent change of ownership
- Jan 1, 2020
- Organization structure
- LLC
- Incorporated
- Jun 23, 2019 in DE
- Enrollment address
- 1901 Libbie Ave
Richmond, VA 23226-1808 - Nursing home name
- GLENBURNIE REHAB & NURSING CENTER
- Affiliated entity
- LIFEWORKS REHAB
Care Compare: Nursing home
Medicare Care Compare- Listed as
- Glenburnie Rehab & Nursing Center
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- For profit - Partnership
- Certified
- Mar 27, 2007
- Medicare certification status
- Active
- Certified beds
- 125
- Chain
- Lifeworks Rehab
- Penalties (3 years)
- 1
National Provider Directory
National Provider DirectoryOwnership & related parties
All disclosed owners & managing parties 10
As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.
| Name | Role | Since | Share |
|---|---|---|---|
| Jkva Holdings LLC | 5% Or Greater Indirect Ownership Interest | Jan 1, 2020 | 29.16% |
| Charles 1994 Family Grantor Trust | 5% Or Greater Indirect Ownership Interest | Jan 1, 2020 | 27.7% |
| Mlva Holdings LLC | 5% Or Greater Indirect Ownership Interest | Jan 1, 2020 | 29.16% |
| Saul 2012 Family Grantor Trust | 5% Or Greater Indirect Ownership Interest | Jan 1, 2020 | 27.7% |
| Virginia Care Holco LLC | 5% Or Greater Direct Ownership Interest | Jan 1, 2020 | |
| Isva Holdings LLC | 5% Or Greater Indirect Ownership Interest | Jan 1, 2020 | 29.16% |
| Moshe Y Rajchenbach | 5% Or Greater Indirect Ownership Interest | Jan 17, 2020 | 100% |
| Corporate Officer | Jan 17, 2020 | 100% | |
| W-2 Managing Employee | Jan 17, 2020 | 100% | |
| Pamela Mitchell | W-2 Managing Employee | Aug 18, 2022 | 100% |
| Other | Aug 18, 2022 | ||
| Edward 1998 Family Grantor Trust | 5% Or Greater Indirect Ownership Interest | Jan 1, 2020 | 24.85% |
| Innovative Healthcare Management LLC | Operational/Managerial Control | Dec 1, 2019 | 100% |
Facilities with the same owner 39
Facilities that share an organizational owner with 5% or greater ownership or operational control.
-
dba Albermarle Health & Rehabilitation Center
- Skilled Nursing Facility
- Charlottesville, VA
- NPI 1003490277
Charles 1994 Family Grantor Trust, Edward 1998 Family Grantor Trust, Saul 2012 Family Grantor Trust
-
dba Appomattox Health & Rehabilitation Center
- Skilled Nursing Facility
- Appomattox, VA
- NPI 1639753809
Charles 1994 Family Grantor Trust, Edward 1998 Family Grantor Trust, Saul 2012 Family Grantor Trust
-
dba Bayside Health & Rehabilitation Center
- Skilled Nursing Facility
- Virginia Beach, VA
- NPI 1528642790
Charles 1994 Family Grantor Trust, Edward 1998 Family Grantor Trust
-
dba Beaufont Health & Rehabilitation Center
- Skilled Nursing Facility
- Richmond, VA
- NPI 1508440785
Charles 1994 Family Grantor Trust, Edward 1998 Family Grantor Trust, Saul 2012 Family Grantor Trust
-
dba Berkshire Health & Rehabilitation Center
- Skilled Nursing Facility
- Vinton, VA
- NPI 1861076044
Charles 1994 Family Grantor Trust, Edward 1998 Family Grantor Trust, Saul 2012 Family Grantor Trust
-
dba Bowling Green Health & Rehabilitation Center
- Skilled Nursing Facility
- Bowling Green, VA
- NPI 1619551801
Charles 1994 Family Grantor Trust, Edward 1998 Family Grantor Trust, Saul 2012 Family Grantor Trust
-
dba Burke Health & Rehabilitation Center
- Skilled Nursing Facility
- Burke, VA
- NPI 1861076051
Charles 1994 Family Grantor Trust, Edward 1998 Family Grantor Trust, Saul 2012 Family Grantor Trust
-
dba Charlottesville Health & Rehabilitation Center
- Skilled Nursing Facility
- Charlottesville, VA
- NPI 1487238671
Charles 1994 Family Grantor Trust, Edward 1998 Family Grantor Trust, Saul 2012 Family Grantor Trust
-
dba Chesapeake Health & Rehabilitation Center
- Skilled Nursing Facility
- Chesapeake, VA
- NPI 1649854837
Charles 1994 Family Grantor Trust, Edward 1998 Family Grantor Trust, Saul 2012 Family Grantor Trust
-
dba Colonial Heights Rehabilitation and Nursing Center
- Skilled Nursing Facility
- Colonial Heights, VA
- NPI 1275174567
Isva Holdings LLC, Jkva Holdings LLC, Mlva Holdings LLC, Virginia Care Holco LLC
-
dba Culpeper Health & Rehabilitation Center
- Skilled Nursing Facility
- Culpeper, VA
- NPI 1265016455
Charles 1994 Family Grantor Trust, Edward 1998 Family Grantor Trust, Saul 2012 Family Grantor Trust
-
dba Fairfax Rehabilitation and Nursing Center
- Skilled Nursing Facility
- Fairfax, VA
- NPI 1033718382
Charles 1994 Family Grantor Trust, Edward 1998 Family Grantor Trust, Innovative Healthcare Management LLC, Isva Holdings LLC, Jkva Holdings LLC, Mlva Holdings LLC, Saul 2012 Family Grantor Trust, Virginia Care Holco LLC
Practitioners & affiliated clinicians
Affiliated clinicians 3
Clinicians who list this facility as an affiliation in Medicare Care Compare.
-
- Internal Medicine Physician
- Richmond, VA
- NPI 1982021895
Nursing home
-
- Geriatric Medicine (Internal Medicine) Physician
- Richmond, VA
- NPI 1417049974
Nursing home
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1570492800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1578528000000",
"number": "1073154373",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1901 LIBBIE AVE",
"city": "RICHMOND",
"state": "VA",
"postal_code": "232261808"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1901 LIBBIE AVE",
"city": "RICHMOND",
"state": "VA",
"postal_code": "232261808",
"telephone_number": "804-281-3500"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "GLENBURNIE OPERATOR LLC",
"organizational_subpart": "NO",
"enumeration_date": "2019-10-08",
"last_updated": "2020-01-09",
"certification_date": "2020-01-09",
"status": "A",
"authorized_official_last_name": "FISCHER",
"authorized_official_first_name": "ELAZAR",
"authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
"authorized_official_telephone_number": "804-281-3500"
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Glenburnie Rehabilitation and Nursing Center",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Richmond, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.