Whites Creek Operating Group LLC
Organization Active NPI Skilled Nursing Facility · Whites Creek, TN
NPI 1114580248 · NPPES record last updated Apr 15, 2019
Key facts
- NPI
- 1114580248
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Skilled Nursing Facility 314000000X
- Legal business name
- WHITES CREEK OPERATING GROUP LLC
- Practice address
- 3425 Knight Dr
Whites Creek, TN 37189-9189 - Phone
- (615) 876-2754
- NPI assigned
- Apr 15, 2019
- Organization subpart
- No
Authorized official
- Name
- Anshel Niederman
- Title
- Manager
- Phone
- (629) 900-2005
Facilities with the same owner 29
Practitioners 1
-
Donald E Vollmer II, M.D.
Medicare Care Compare: Nursing home
- Listed as
- Whites Creek Wellness and Rehabilitation Center
- Overall star rating
- ★★★☆☆ 3 of 5
- Health inspections
- ★★★☆☆ 3 of 5
- Staffing
- ★☆☆☆☆ 1 of 5
- Quality measures
- ★★★★★ 5 of 5
- Type
- Medicare and Medicaid
- Ownership
- For profit - Corporation
- Certified
- May 4, 1992
- Medicare certification status
- Active
- Certified beds
- 127 · 110.6 residents per day on average
- Chain
- Ahava Healthcare
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 44D0716533 | Whites Creek Operating Group | Certificate of waiver | Aug 31, 2026 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TN
Skilled nursing facility certification: CCN 445281
- Legal name
- WHITES CREEK OPERATING GROUP LLC
- Doing business as
- WHITES CREEK WELLNESS AND REHABILITATION CENTER
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- May 4, 1992
- Last certification
- Jul 14, 2021
- Beds
- 127
- Ownership / control type
- Corporation
- Multi-facility organization
- Ahava Healthcare
- Organization structure
- LLC · Proprietary
- Enrollment address
- 3425 Knight Dr
Whites Creek, TN 37189-9189 - Nursing home name
- WHITES CREEK WELLNESS AND REHABILITATION CENTER
- Affiliated entity
- AHAVA HEALTHCARE
All disclosed owners & managing parties 14
| Name | Role | Since | Share |
|---|---|---|---|
| Benjamin Neuman |
5% Or Greater Indirect Ownership Interest | Jun 1, 2019 | 10% |
| Avi Philipson |
Other | Mar 21, 2023 | 3.34% |
| Bent Philipson |
5% Or Greater Indirect Ownership Interest | Jun 1, 2019 | 10% |
| Ecm Holdings LLC |
5% Or Greater Indirect Ownership Interest | Jun 1, 2019 | 10% |
| Benjamin Todd McGovern |
W-2 Managing Employee |
Jun 1, 2019 | |
| Tracie Leech |
W-2 Managing Employee |
Jun 1, 2019 | |
| Shiya Labin |
5% Or Greater Indirect Ownership Interest | Jun 1, 2019 | 10% |
| Whites Creek Holdco LLC |
5% Or Greater Direct Ownership Interest | Jun 1, 2019 | 100% |
| Anshel Niederman |
5% Or Greater Indirect Ownership Interest | Jun 1, 2019 | 50% |
| Corporate Officer |
Jun 1, 2019 | ||
| Raquel Philipson |
Other | Mar 21, 2023 | 3.33% |
| Philipson Family Limited Liability Company, LLC |
5% Or Greater Indirect Ownership Interest | Jun 1, 2019 | 20% |
| VNB New York LLC |
5% Or Greater Security Interest | Jun 1, 2019 | |
| Menashe Eisen |
5% Or Greater Indirect Ownership Interest | Jun 1, 2019 | 10% |
| Gabrielle Philipson |
Other | Mar 21, 2023 | 3.33% |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20191022001122 | TN | Part a Provider - Skilled Nursing Facility | 5890027072 | Practice locations: Whites Creek, TN |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | Yes |
Addresses
Primary practice location
3425 Knight Dr
Whites Creek, TN 37189-9189
Mailing address
544 Park Ave Ste B04
Brooklyn, NY 11205-1670
Phone (917) 682-3129
Other providers in Whites Creek, TN
- Roslyn K Pope
- The Blue Van LLC
- Caroline Harber Vantrease
- Eboni Nicole Webb
- Whites Creek Healthcare LLC
All providers in Whites Creek, TN · Skilled Nursing Facility in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 15, 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.