Organization Active NPI

Shippenville PA Opco LLC

Doing business as Shippenville Nursing and Rehab

  • Skilled Nursing Facility
  • Shippenville, PA
National Provider Identifier
1083467294
Registry record updated Apr 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
SHIPPENVILLE PA OPCO LLC
Doing business as
Shippenville Nursing and Rehab
Practice address
21158 Paint Blvd
Shippenville, PA 16254-4024
Phone
(814) 226-5660
NPI assigned
Apr 8, 2024
Last updated
Apr 8, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2024

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

Authorized official

Name
Mr. Aharon Franco
Title
Authorized Representative
Phone
(646) 823-6464

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

21158 Paint Blvd
Shippenville, PA 16254-4024

Mailing address

1815 Lakewood Road
Suite 255
Toms River, NJ 08755

Other names 1

  • Shippenville Nursing and Rehab Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20241217003459 PA Part A Provider - Skilled Nursing Facility 8527595404 Practice locations: Shippenville, PA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1083467294. Details of each certification follow.

Skilled nursing facility certification: CCN 395607

Legal name
SHIPPENVILLE PA OPCO LLC
Doing business as
SHIPPENVILLE NURSING AND REHAB
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Nov 7, 1983
Last certification
Jun 13, 2025
Beds
120
Ownership / control type
Limited Liability Corporation
Organization structure
LLCProprietary
Enrollment address
21158 Paint Blvd
Shippenville, PA 16254-4024
Nursing home name
SHIPPENVILLE NURSING AND REHAB
Affiliated entity
VALLEY WEST HEALTH

Care Compare: Nursing home

Medicare Care Compare
Listed as
Shippenville Nursing and RehabCCN 395607 · All quality measures
Overall star rating
3 of 5
Health inspections
3 of 5
Staffing
2 of 5
Quality measures
3 of 5
Type
Medicare and Medicaid
Ownership
For profit - Limited Liability company
Certified
Nov 7, 1983
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
12096.3 residents per day on average
Chain
Valley West Health12 facilities in the chain

Processed by Care Compare on Aug 1, 2026.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
39D0183336Shippenville Nursing & Rehab21158 Paint Boulevard, Shippenville, PA 16254Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 28

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Valley West Health LLC Organization, Toms River, NJ LLC, Medical provider/supplier, For-profit Operational/Managerial Control Jan 24, 2025
Adp of the SNF Dec 17, 2024
Fillmore Strategic Investors LLC Organization, Chicago, IL LLC, For-profit Adp of the SNF Dec 17, 2024
Barbara Hicks Individual Adp of the SNF Dec 17, 2024
Susen a Rossino Individual Adp of the SNF Dec 17, 2024
Washington State Investment Board Organization, Olympia, WA For-profit Adp of the SNF Dec 17, 2024
Melissa Polito Individual Adp of the SNF Dec 17, 2024
Isaac Rami Individual Operational/Managerial Control Jan 24, 2025
Adp of the SNF Jan 24, 2025
Surety Compliance Organization, Southlake, TX Consulting firm, For-profit Adp of the SNF Jan 24, 2025
Iskeb 2024 Trust Organization, Toms River, NJ Created for acquisition, For-profit 5% Or Greater Indirect Ownership Interest Oct 29, 2024 95%
Adp of the SNF Jan 24, 2025
Heather Andrews Individual Adp of the SNF Jan 24, 2025
Drumm Merger Co Organization, San Francisco, CA Holding company, For-profit Adp of the SNF Dec 17, 2024
Holly a Rasmussen-Jones Individual Adp of the SNF Jan 24, 2025
Pearl Senior Care, LLC. Organization, Frisco, TX LLC, For-profit Adp of the SNF Dec 17, 2024
Drumm Intermediary Sub Co LLC Organization, San Francisco, CA LLC, For-profit Adp of the SNF Dec 17, 2024
Iskeb Western PA LLC Organization, Toms River, NJ Created for acquisition, LLC, For-profit 5% Or Greater Indirect Ownership Interest Oct 29, 2024 95%
Adp of the SNF Dec 17, 2024
Beverly Enterprises LLC Organization, Frisco, TX For-profit Adp of the SNF Dec 17, 2024
Drumm Merger Co Sub LLC Organization, San Francisco, CA LLC, For-profit Adp of the SNF Dec 17, 2024
Beverly Enterprises - Pennsylvania, Inc. Organization, Frisco, TX LLC, For-profit Adp of the SNF Dec 17, 2024
Beverly Health and Rehabilitiation Services, Inc Organization, Frisco, TX For-profit Adp of the SNF Dec 17, 2024
Geary Property Holdings LLC Organization, Frisco, TX LLC, For-profit Adp of the SNF Dec 17, 2024
Kim Linam Individual Adp of the SNF Jan 24, 2025
Aharon Franco Individual 5% Or Greater Indirect Ownership Interest Oct 29, 2024 5%
Operational/Managerial Control Jan 24, 2025
Adp of the SNF Jan 24, 2025
Jean Miller Individual Adp of the SNF Jan 24, 2025
Keystone Ventures LLC Organization, Toms River, NJ Created for acquisition, LLC 5% Or Greater Indirect Ownership Interest Oct 29, 2024 5%
Adp of the SNF Dec 17, 2024
GPH Shippenville LP Organization, Frisco, TX For-profit Adp of the SNF Dec 17, 2024
Western PA Opco Holdings I LLC Organization, Toms River, NJ Created for acquisition, LLC 5% Or Greater Direct Ownership Interest Oct 29, 2024 100%
Adp of the SNF Dec 17, 2024
Sarah Karity Individual 5% Or Greater Indirect Ownership Interest Oct 29, 2024 95%
Adp of the SNF Jan 24, 2025
Nicholas R Finn Individual Adp of the SNF Jan 24, 2025

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 11

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

Affiliated clinicians 2

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1712534400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1712534400000",
    "number": "1083467294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1815 LAKEWOOD ROAD",
            "address_2": "SUITE 255",
            "city": "TOMS RIVER",
            "state": "NJ",
            "postal_code": "08755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21158 PAINT BLVD",
            "city": "SHIPPENVILLE",
            "state": "PA",
            "postal_code": "162544024",
            "telephone_number": "814-226-5660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHIPPENVILLE PA OPCO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-04-08",
        "last_updated": "2024-04-08",
        "certification_date": "2024-04-04",
        "status": "A",
        "authorized_official_last_name": "FRANCO",
        "authorized_official_first_name": "AHARON",
        "authorized_official_title_or_position": "AUTHORIZED REPRESENTATIVE",
        "authorized_official_telephone_number": "646-823-6464",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Shippenville Nursing and Rehab",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Shippenville, PA

Sources for this page

Verify at the official NPI Registry.