Organization Active NPI

Chestnut SNF Operations LLC

  • Skilled Nursing Facility
  • Louisville, KY
National Provider Identifier
1154130540
Registry record updated Dec 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
CHESTNUT SNF OPERATIONS LLC
Practice address
1015 Magazine St
Louisville, KY 40203-2017
Phone
(502) 815-6460
NPI assigned
Dec 31, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 31, 2024

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

Authorized official

Name
Dillion Carver
Title
Regional Director of Operations
Phone
(270) 784-4469

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

1015 Magazine St
Louisville, KY 40203-2017

Mailing address

1015 Magazine St
Louisville, KY 40203-2017
Phone (502) 815-6460

Other names 1

  • Chestnut Ridge Health & Rehabilitation Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20251007002357 KY Part A Provider - Skilled Nursing Facility 2365949369 Practice locations: Louisville, KY

Skilled nursing facility certification: CCN 185468

Legal name
CHESTNUT SNF OPERATIONS LLC
Doing business as
CHESTNUT RIDGE HEALTH & REHABILITATION
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Apr 3, 2012
Last certification
Aug 7, 2023
Beds
92
Ownership / control type
Limited Liability Corporation
Multi-facility organization
Lyon Healthcare
Organization structure
LLCProprietary
Enrollment address
1015 Magazine St
Louisville, KY 40203-2017
Nursing home name
CHESTNUT RIDGE HEALTH & REHABILITATION
Affiliated entity
LYON HEALTHCARE

Care Compare: Nursing home

Medicare Care Compare
Listed as
Chestnut Ridge Health & RehabilitationCCN 185468
Overall star rating
1 of 5
Health inspections
1 of 5
Staffing
1 of 5
Quality measures
4 of 5
Type
Medicare and Medicaid
Ownership
For profit - Limited Liability company
Certified
Apr 3, 2012
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
9271.4 residents per day on average
Chain
Lyon Healthcare11 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 45

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

NameRoleSinceShare
Individual Indirect Ownership Interest Jan 1, 2025 0.5%
Organization, Woodmere, NY LLC, Holding company Indirect Ownership Interest Jan 2, 2025 1%
Ky 10 SNF Operations Holdings LLC Organization, Woodmere, NY LLC, Holding company 5% Or Greater Direct Ownership Interest Jan 2, 2025 100%
Operational/Managerial Control Jan 2, 2025
Adp of the SNF Jan 2, 2025
Siky Trust Organization, Las Vegas, NV 5% Or Greater Indirect Ownership Interest Jan 2, 2025 21.5%
MJL 2024 Family Trust Organization, West Hempstead, NY Indirect Ownership Interest Jan 1, 2025 1.25%
Ky10 SNF Opco Manager LLC Organization, Louisville, KY LLC Operational/Managerial Control Jan 1, 2025
Individual Indirect Ownership Interest Jan 1, 2025 0.5%
Individual Indirect Ownership Interest Jan 1, 2025 0.5%
LTC Consulting Services LLC Organization, Lakewood, NJ LLC Adp of the SNF Apr 7, 2025
Roth & Co, LLP Organization, Brooklyn, NY Consulting firm Adp of the SNF Jan 1, 2025
Dillion C Carver Individual Operational/Managerial Control Jan 1, 2025
Individual Indirect Ownership Interest Jan 1, 2025 0.5%
Individual Indirect Ownership Interest Jan 1, 2025 0.5%
Individual Indirect Ownership Interest Jan 1, 2025 0.5%
Ssky Trust Organization, Las Vegas, NV 5% Or Greater Indirect Ownership Interest Jan 2, 2025 20.75%
JNL 2024 Fam TR Organization, West Hempstead, NY Indirect Ownership Interest Jan 1, 2025 1.25%
Individual Indirect Ownership Interest Jan 1, 2025 0.5%
Individual Indirect Ownership Interest Jan 1, 2025 0.5%
Debra Hackett Individual Operational/Managerial Control Jan 1, 2025
Adp of the SNF Jan 1, 2025
HVH Ky 10 SNF Consulting LLC Organization, Louisville, KY LLC, Consulting firm Adp of the SNF Jan 1, 2025
Individual Indirect Ownership Interest Jan 1, 2025 0.5%
JML 1836 Holdings LLC Organization, West Hempstead, NY LLC, Investment firm, Owned by another organization or individual Indirect Ownership Interest Jan 1, 2025 2.5%
Epky Trust Organization, Las Vegas, NV 5% Or Greater Indirect Ownership Interest Jan 2, 2025 20.75%
Lion Ky Holdings LLC Organization, Woodmere, NY LLC, Holding company 5% Or Greater Indirect Ownership Interest Jan 1, 2025 41.5%
Shimon Idels Individual Operational/Managerial Control Jan 1, 2025
Adp of the SNF Jan 1, 2005
Individual Indirect Ownership Interest Jan 1, 2025 0.5%
Lyon Healthcare LLC Organization, Louisville, KY LLC, Consulting firm Adp of the SNF Jan 1, 2025
Michael Botwinick Individual Indirect Ownership Interest Jan 1, 2025 1%
Individual Indirect Ownership Interest Jan 1, 2025 0.5%
Organization, Woodmere, NY LLC Indirect Ownership Interest Jan 2, 2025 0.5%
Individual Indirect Ownership Interest Jan 1, 2025 0.5%
Individual Indirect Ownership Interest Jan 1, 2025 0.5%
Individual Indirect Ownership Interest Jan 1, 2025 0.5%
Tziporah Schwartz 2017 Family Trust Organization, Woodmere, NY Indirect Ownership Interest Jan 1, 2025 0.25%
Individual Indirect Ownership Interest Jan 1, 2025 0.5%
Organization, Woodmere, NY LLC, Holding company Indirect Ownership Interest Jan 2, 2025 2.5%
Hiky Trust Organization, Las Vegas, NV 5% Or Greater Indirect Ownership Interest Jan 2, 2025 21.5%
Joel a Schwartz 2017 Family Trust Organization, Woodmere, NY Indirect Ownership Interest Jan 1, 2025 0.25%
Individual Indirect Ownership Interest Jan 1, 2025 0.12%
Individual Indirect Ownership Interest Jan 1, 2025 0.5%
Individual Indirect Ownership Interest Jan 1, 2025 0.5%
Sherita Autrey Individual Operational/Managerial Control Jan 1, 2025
Managing Control - Governing BodyAdministrator Jan 1, 2025
Adp of the SNF Jan 1, 2025
Organization, Woodmere, NY LLC, Holding company Indirect Ownership Interest Jan 2, 2025 0.5%
BTF Ky Holdings LLC Organization, Woodmere, NY LLC, Investment firm 5% Or Greater Indirect Ownership Interest Jan 2, 2025 43%
Robert C Anderson Individual Operational/Managerial Control Mar 10, 2025
Managing Control - Governing BodyRegional Director of Operations Mar 10, 2025
Adp of the SNF Mar 10, 2025

Facilities with the same owner 4

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

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1735603200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1735603200000",
    "number": "1154130540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1015 MAGAZINE ST",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402032017",
            "telephone_number": "502-815-6460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1015 MAGAZINE ST",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402032017",
            "telephone_number": "502-815-6460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHESTNUT SNF OPERATIONS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-12-31",
        "last_updated": "2024-12-31",
        "certification_date": "2024-12-31",
        "status": "A",
        "authorized_official_last_name": "CARVER",
        "authorized_official_first_name": "DILLION",
        "authorized_official_title_or_position": "REGIONAL DIRECTOR OF OPERATIONS",
        "authorized_official_telephone_number": "270-784-4469"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Chestnut Ridge Health & Rehabilitation",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.