Active NPI
Mulberry at Waverly LLC
- Skilled Nursing Facility
- Waverly, NE
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- Legal business name
- MULBERRY AT WAVERLY LLC
- Practice address
- 11041 N 137TH St
Waverly, NE 68462-1022 - Phone
- (402) 786-2626
- Fax
- (402) 786-2630
- NPI assigned
- Jul 26, 2023
- 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
- Ari Silberstein
- Title
- Authorized Official
- Phone
- (402) 786-2626
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | Primary |
Addresses
Primary practice location
11041 N 137TH St
Waverly, NE 68462-1022
Mailing address
265 E Merrick Rd Ste 205
Valley Stream, NY 11580-6004
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NE
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20230928000040 | NE | Part A Provider - Skilled Nursing Facility | 4082068895 | Practice locations: Waverly, NE |
Skilled nursing facility certification: CCN 285143
- Legal name
- MULBERRY AT WAVERLY LLC
- Doing business as
- THE MULBERRY AT WAVERLY
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Jun 1, 1994
- Last certification
- Dec 5, 2024
- Beds
- 54
- Ownership / control type
- Corporation
- Multi-facility organization
- Adept
- Most recent change of ownership
- Aug 2, 2023
- Organization structure
- LLC
- Enrollment address
- 11041 N 137TH St
Waverly, NE 68462-1022 - Nursing home name
- ADEPT NURSING & REHAB OF WAVERLY
- Affiliated entity
- AVID HEALTHCARE GROUP
Care Compare: Nursing home
Medicare Care Compare- Listed as
- Adept Nursing & Rehab of Waverly
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- For profit - Corporation
- Certified
- Jun 1, 1994
- Medicare certification status
- Active
- Certified beds
- 54
- Chain
- Avid Healthcare Group
- Penalties (3 years)
- 4
National Provider Directory
National Provider DirectoryOwnership & related parties
All disclosed owners & managing parties 13
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 |
|---|---|---|---|
| SF 4140 Olde Washington Boulevard Real Property LLC | 5% Or Greater Indirect Ownership Interest | Aug 1, 2023 | 33% |
| Copper NE Trust | 5% Or Greater Indirect Ownership Interest | Aug 2, 2023 | 16% |
| NE 11 Holdings Opco LLC | 5% Or Greater Direct Ownership Interest | Aug 2, 2023 | 100% |
| David Weisz | 5% Or Greater Indirect Ownership Interest | Aug 2, 2023 | 33% |
| Silver NE Trust | 5% Or Greater Indirect Ownership Interest | Aug 2, 2023 | 13% |
| Brass NE Trust | 5% Or Greater Indirect Ownership Interest | Aug 2, 2023 | 16.5% |
| Tulip Investments NE LLC | 5% Or Greater Indirect Ownership Interest | Aug 2, 2023 | 33% |
| BSD Beis Health Trust | 5% Or Greater Indirect Ownership Interest | Aug 2, 2023 | 16.5% |
| Douro Valley Investment, LLC | 5% Or Greater Direct Ownership Interest | Aug 2, 2023 | 33% |
| Ari Silberstein | Corporate Officer | Aug 2, 2023 | |
| NE SNF Holdings LLC | 5% Or Greater Indirect Ownership Interest | Aug 2, 2023 | 33% |
| Gold NE Trust | 5% Or Greater Indirect Ownership Interest | Aug 2, 2023 | 13% |
| Lindsey Pihlgren | W-2 Managing Employee | Aug 2, 2023 |
Facilities with the same owner 10
Facilities that share an organizational owner with 5% or greater ownership or operational control.
-
- Skilled Nursing Facility
- Omaha, NE
- NPI 1780365403
Brass NE Trust, BSD Beis Health Trust, Douro Valley Investment, LLC, Gold NE Trust, NE SNF Holdings LLC, SF 4140 Olde Washington Boulevard Real Property LLC, Silver NE Trust, Tulip Investments NE LLC
-
- Skilled Nursing Facility
- Sutherland, NE
- NPI 1689355315
Brass NE Trust, BSD Beis Health Trust, Copper NE Trust, Douro Valley Investment, LLC, Gold NE Trust, NE 11 Holdings Opco LLC, NE SNF Holdings LLC, SF 4140 Olde Washington Boulevard Real Property LLC, Silver NE Trust, Tulip Investments NE LLC
-
- Skilled Nursing Facility
- Grand Island, NE
- NPI 1174204887
Brass NE Trust, BSD Beis Health Trust, Copper NE Trust, Douro Valley Investment, LLC, Gold NE Trust, NE 11 Holdings Opco LLC, NE SNF Holdings LLC, SF 4140 Olde Washington Boulevard Real Property LLC, Silver NE Trust, Tulip Investments NE LLC
-
- Skilled Nursing Facility
- Omaha, NE
- NPI 1487335154
Brass NE Trust, BSD Beis Health Trust, Douro Valley Investment, LLC, Gold NE Trust, NE SNF Holdings LLC, SF 4140 Olde Washington Boulevard Real Property LLC, Silver NE Trust, Tulip Investments NE LLC
-
- Skilled Nursing Facility
- North Platte, NE
- NPI 1679254387
Brass NE Trust, BSD Beis Health Trust, Copper NE Trust, Douro Valley Investment, LLC, Gold NE Trust, NE 11 Holdings Opco LLC, NE SNF Holdings LLC, SF 4140 Olde Washington Boulevard Real Property LLC, Silver NE Trust, Tulip Investments NE LLC
-
- Skilled Nursing Facility
- Ashland, NE
- NPI 1750061644
Brass NE Trust, BSD Beis Health Trust, Copper NE Trust, Douro Valley Investment, LLC, Gold NE Trust, NE 11 Holdings Opco LLC, NE SNF Holdings LLC, SF 4140 Olde Washington Boulevard Real Property LLC, Silver NE Trust, Tulip Investments NE LLC
-
- Skilled Nursing Facility
- Central City, NE
- NPI 1578244299
Brass NE Trust, BSD Beis Health Trust, Copper NE Trust, Douro Valley Investment, LLC, Gold NE Trust, NE 11 Holdings Opco LLC, NE SNF Holdings LLC, SF 4140 Olde Washington Boulevard Real Property LLC, Silver NE Trust, Tulip Investments NE LLC
-
- Skilled Nursing Facility
- South Sioux City, NE
- NPI 1598446221
Brass NE Trust, BSD Beis Health Trust, Copper NE Trust, Douro Valley Investment, LLC, Gold NE Trust, NE 11 Holdings Opco LLC, NE SNF Holdings LLC, SF 4140 Olde Washington Boulevard Real Property LLC, Silver NE Trust, Tulip Investments NE LLC
-
- Skilled Nursing Facility
- Blue Hill, NE
- NPI 1710668421
Brass NE Trust, BSD Beis Health Trust, Copper NE Trust, Douro Valley Investment, LLC, Gold NE Trust, NE 11 Holdings Opco LLC, NE SNF Holdings LLC, SF 4140 Olde Washington Boulevard Real Property LLC, Silver NE Trust, Tulip Investments NE LLC
-
- Skilled Nursing Facility
- Gretna, NE
- NPI 1558042275
Brass NE Trust, BSD Beis Health Trust, Copper NE Trust, Douro Valley Investment, LLC, Gold NE Trust, NE 11 Holdings Opco LLC, NE SNF Holdings LLC, SF 4140 Olde Washington Boulevard Real Property LLC, Silver NE Trust, Tulip Investments NE LLC
Practitioners & affiliated clinicians
Practitioners 2
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Internal Medicine Physician
- Omaha, NE
- NPI 1932117470
-
- Family Medicine Physician
- Omaha, NE
- NPI 1790767713
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": "1690329600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1696550400000",
"number": "1124709852",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "265 E MERRICK RD STE 205",
"city": "VALLEY STREAM",
"state": "NY",
"postal_code": "115806004"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11041 N 137TH ST",
"city": "WAVERLY",
"state": "NE",
"postal_code": "684621022",
"telephone_number": "402-786-2626",
"fax_number": "402-786-2630"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MULBERRY AT WAVERLY LLC",
"organizational_subpart": "NO",
"enumeration_date": "2023-07-26",
"last_updated": "2023-10-06",
"certification_date": "2023-10-06",
"status": "A",
"authorized_official_last_name": "SILBERSTEIN",
"authorized_official_first_name": "ARI",
"authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
"authorized_official_telephone_number": "402-786-2626"
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Waverly, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2023; 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.