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Organization Active NPI

Robertsdale Nursing Home Inc

  • Skilled Nursing Facility
  • Robertsdale, AL
National Provider Identifier
1124066923
Registry record updated Mar 31, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
12479 Issued in AL
Legal business name
ROBERTSDALE NURSING HOME INC
Practice address
18700 US Highway 90
Robertsdale, AL 36567-3271
Phone
(251) 947-1911
Fax
(251) 947-1937
NPI assigned
Jun 3, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2016

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

Authorized official

Name
Mrs. Mary Kay Polys
Title
Administrator
Phone
(251) 947-1911

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 12479 AL Primary

Addresses

Primary practice location

18700 US Highway 90
Robertsdale, AL 36567-3271

Mailing address

1 Southern Way
Mobile, AL 36619-1210
Phone (251) 433-9801

Other identifiers 1

IdentifierTypeStateIssuer
475807OSMedicaidAL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070130000150 AL Part A Provider - Skilled Nursing Facility 9830190115 Practice locations: Robertsdale, AL

Skilled nursing facility certification: CCN 015443

Legal name
ROBERTSDALE NURSING HOME INC
Doing business as
ROBERTSDALE REHABILITATION & HEALTHCARE CENTER
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Mar 16, 2001
Last certification
Aug 8, 2024
Beds
152
Ownership / control type
Corporation
Multi-facility organization
BALL HEALTHCARE SERVICES INC
Organization structure
CorporationProprietary
Incorporated
Dec 22, 1998 in AL
Enrollment address
18700 US Highway 90
Robertsdale, AL 36567-3271
Nursing home name
ROBERTSDALE REHABILITATION & HEALTHCARE CTR
Affiliated entity
BALL HEALTHCARE SERVICES

Care Compare: Nursing home

Medicare Care Compare
Listed as
Robertsdale Rehabilitation & Healthcare CtrCCN 015443
Overall star rating
2 of 5
Health inspections
2 of 5
Staffing
4 of 5
Quality measures
3 of 5
Type
Medicare and Medicaid
Ownership
For profit - Corporation
Certified
Mar 16, 2001
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
152117.5 residents per day on average
Chain
Ball Healthcare Services9 facilities in the chain

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 4

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

NameRoleSinceShare
Clarence Melvin Ball Individual 5% Or Greater Direct Ownership Interest Oct 22, 1998 100%
Corporate OfficerCeo Dec 22, 1998
Ball Healthcare Service, Inc Organization, Mobile, AL For-profit Operational/Managerial Control Dec 22, 1998
Matthew Hall Individual Corporate OfficerCfo Oct 1, 2014
Frederick Skelton Individual W-2 Managing EmployeeAdministrator Dec 20, 2022

Facilities with the same owner 3

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

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

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": "1149292800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1459382400000",
    "number": "1124066923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 SOUTHERN WAY",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366191210",
            "telephone_number": "251-433-9801",
            "fax_number": "251-433-9807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18700 US HIGHWAY 90",
            "city": "ROBERTSDALE",
            "state": "AL",
            "postal_code": "365673271",
            "telephone_number": "251-947-1911",
            "fax_number": "251-947-1937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBERTSDALE NURSING HOME INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-03",
        "last_updated": "2016-03-31",
        "status": "A",
        "authorized_official_last_name": "POLYS",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "KAY",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "251-947-1911",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "AL",
            "license": "12479",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "475807OS",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Robertsdale, AL

Sources for this page

Verify at the official NPI Registry.