NPIMap

Organization Active NPI

South Roanoke Life Care, LLC

Doing business as South Roanoke Nursing Home

  • Skilled Nursing Facility
  • Roanoke, VA
National Provider Identifier
1093799439
Registry record updated Nov 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
49-5002 Issued in VA
Legal business name
SOUTH ROANOKE LIFE CARE, LLC
Doing business as
South Roanoke Nursing Home
South Roanoke Nursing and Rehabilitation
Practice address
3823 Franklin Rd SW
Roanoke, VA 24014
Phone
(540) 344-4325
Fax
(540) 342-0316
NPI assigned
Nov 30, 2005
Last updated
Nov 3, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2025

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

Authorized official

Name
Cassandra Gallant
Title
Compliance & Privacy Officer
Phone
(540) 774-4263

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 49-5002 VA Primary

Addresses

Primary practice location

3823 Franklin Rd SW
Roanoke, VA 24014

Mailing address

3823 Franklin Rd SW
Roanoke, VA 24014
Phone (540) 344-4325

Other names 2

  • South Roanoke Nursing Home Doing business as
  • South Roanoke Nursing and Rehabilitation Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190730002628 VA Part A Provider - Skilled Nursing Facility 1254667108 Practice locations: Roanoke, VA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1093799439. Details of each certification follow.

Skilled nursing facility certification: CCN 495002

Legal name
SOUTH ROANOKE LIFE CARE LLC
Doing business as
SOUTH ROANOKE NURSING AND REHABILITATION
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Jan 1, 1967
Last certification
Apr 24, 2025
Beds
98
Ownership / control type
Corporation
Multi-facility organization
American Healthcare LLC
Organization structure
LLCProprietary
Incorporated
Jan 11, 2019 in VA
Enrollment address
3823 Franklin Rd SW
Roanoke, VA 24014-3043
Nursing home name
SOUTH ROANOKE NURSING AND REHABILITATION
Affiliated entity
HERITAGE HALL

Care Compare: Nursing home

Medicare Care Compare
Listed as
South Roanoke Nursing and RehabilitationCCN 495002 · All quality measures
Overall star rating
3 of 5
Health inspections
2 of 5
Staffing
3 of 5
Quality measures
5 of 5
Type
Medicare and Medicaid
Ownership
For profit - Corporation
Certified
Jan 1, 1967
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
9890.7 residents per day on average
Chain
Heritage Hall15 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
49D0892590South Roanoke Life Care, LLC3823 Franklin Rd, Roanoke, VA 24014Certificate of waiverFeb 3, 2028

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 8

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

NameRoleSinceShare
William B Hopkins Individual Corporate DirectorDir Jun 1, 2019 100%
Brad Dalton Individual Corporate OfficerSecretary Jul 11, 2024
Operational/Managerial Control Jul 11, 2024
Adp of the SNF Jul 11, 2024
William C Mitchell Individual Adp of the SNF Oct 2, 2024
Christian Champney Individual Operational/Managerial Control Oct 2, 2024
Adp of the SNF Oct 2, 2024
Cassandra Gallant Individual Operational/Managerial Control Jul 11, 2024
Adp of the SNF Jul 11, 2024
Thomas East Individual Corporate OfficerPres/Ceo Jun 1, 2019 100%
American Healthcare LLC Organization, Roanoke, VA LLC, Management services company, Chain home office 5% Or Greater Direct Ownership Interest Jun 1, 2019 100%
Operational/Managerial Control Jan 22, 2018
Adp of the SNF Jan 22, 2018
Robert Dalton Individual Corporate OfficerCfo Jun 1, 2019 75%
Operational/Managerial Control Apr 21, 2014
Adp of the SNF Apr 21, 2014

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 14

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

View all 14

Practitioners & affiliated clinicians

Affiliated clinicians 1

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": "1133308800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1762128000000",
    "number": "1093799439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3823 FRANKLIN RD SW",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "24014",
            "telephone_number": "540-344-4325",
            "fax_number": "540-342-0316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3823 FRANKLIN RD SW",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "24014",
            "telephone_number": "540-344-4325",
            "fax_number": "540-342-0316"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH ROANOKE LIFE CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-30",
        "last_updated": "2025-11-03",
        "certification_date": "2025-11-03",
        "status": "A",
        "authorized_official_last_name": "GALLANT",
        "authorized_official_first_name": "CASSANDRA",
        "authorized_official_title_or_position": "COMPLIANCE & PRIVACY OFFICER",
        "authorized_official_telephone_number": "540-774-4263"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "VA",
            "license": "49-5002",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "South Roanoke Nursing Home",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "South Roanoke Nursing Home",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "South Roanoke Nursing and Rehabilitation",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Roanoke, VA

Sources for this page

Verify at the official NPI Registry.