Active NPI
Chestnut SNF Operations LLC
- Skilled Nursing Facility
- Louisville, KY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in KY
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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
- LLC
- 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 & Rehabilitation
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- For profit - Limited Liability company
- Certified
- Apr 3, 2012
- Medicare certification status
- Active
- Certified beds
- 92
- Chain
- Lyon Healthcare
National Provider Directory
National Provider DirectoryOwnership & 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.
| Name | Role | Since | Share |
|---|---|---|---|
| Indirect Ownership Interest | Jan 1, 2025 | 0.5% | |
| Indirect Ownership Interest | Jan 2, 2025 | 1% | |
| Ky 10 SNF Operations Holdings LLC | 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 | 5% Or Greater Indirect Ownership Interest | Jan 2, 2025 | 21.5% |
| MJL 2024 Family Trust | Indirect Ownership Interest | Jan 1, 2025 | 1.25% |
| Ky10 SNF Opco Manager LLC | Operational/Managerial Control | Jan 1, 2025 | |
| Indirect Ownership Interest | Jan 1, 2025 | 0.5% | |
| Indirect Ownership Interest | Jan 1, 2025 | 0.5% | |
| LTC Consulting Services LLC | Adp of the SNF | Apr 7, 2025 | |
| Roth & Co, LLP | Adp of the SNF | Jan 1, 2025 | |
| Dillion C Carver | Operational/Managerial Control | Jan 1, 2025 | |
| Indirect Ownership Interest | Jan 1, 2025 | 0.5% | |
| Indirect Ownership Interest | Jan 1, 2025 | 0.5% | |
| Indirect Ownership Interest | Jan 1, 2025 | 0.5% | |
| Ssky Trust | 5% Or Greater Indirect Ownership Interest | Jan 2, 2025 | 20.75% |
| JNL 2024 Fam TR | Indirect Ownership Interest | Jan 1, 2025 | 1.25% |
| Indirect Ownership Interest | Jan 1, 2025 | 0.5% | |
| Indirect Ownership Interest | Jan 1, 2025 | 0.5% | |
| Debra Hackett | Operational/Managerial Control | Jan 1, 2025 | |
| Adp of the SNF | Jan 1, 2025 | ||
| HVH Ky 10 SNF Consulting LLC | Adp of the SNF | Jan 1, 2025 | |
| Indirect Ownership Interest | Jan 1, 2025 | 0.5% | |
| JML 1836 Holdings LLC | Indirect Ownership Interest | Jan 1, 2025 | 2.5% |
| Epky Trust | 5% Or Greater Indirect Ownership Interest | Jan 2, 2025 | 20.75% |
| Lion Ky Holdings LLC | 5% Or Greater Indirect Ownership Interest | Jan 1, 2025 | 41.5% |
| Shimon Idels | Operational/Managerial Control | Jan 1, 2025 | |
| Adp of the SNF | Jan 1, 2005 | ||
| Indirect Ownership Interest | Jan 1, 2025 | 0.5% | |
| Lyon Healthcare LLC | Adp of the SNF | Jan 1, 2025 | |
| Michael Botwinick | Indirect Ownership Interest | Jan 1, 2025 | 1% |
| Indirect Ownership Interest | Jan 1, 2025 | 0.5% | |
| Indirect Ownership Interest | Jan 2, 2025 | 0.5% | |
| Indirect Ownership Interest | Jan 1, 2025 | 0.5% | |
| Indirect Ownership Interest | Jan 1, 2025 | 0.5% | |
| Indirect Ownership Interest | Jan 1, 2025 | 0.5% | |
| Tziporah Schwartz 2017 Family Trust | Indirect Ownership Interest | Jan 1, 2025 | 0.25% |
| Indirect Ownership Interest | Jan 1, 2025 | 0.5% | |
| Indirect Ownership Interest | Jan 2, 2025 | 2.5% | |
| Hiky Trust | 5% Or Greater Indirect Ownership Interest | Jan 2, 2025 | 21.5% |
| Joel a Schwartz 2017 Family Trust | Indirect Ownership Interest | Jan 1, 2025 | 0.25% |
| Indirect Ownership Interest | Jan 1, 2025 | 0.12% | |
| Indirect Ownership Interest | Jan 1, 2025 | 0.5% | |
| Indirect Ownership Interest | Jan 1, 2025 | 0.5% | |
| Sherita Autrey | Operational/Managerial Control | Jan 1, 2025 | |
| Managing Control - Governing Body | Jan 1, 2025 | ||
| Adp of the SNF | Jan 1, 2025 | ||
| Indirect Ownership Interest | Jan 2, 2025 | 0.5% | |
| BTF Ky Holdings LLC | 5% Or Greater Indirect Ownership Interest | Jan 2, 2025 | 43% |
| Robert C Anderson | Operational/Managerial Control | Mar 10, 2025 | |
| Managing Control - Governing Body | 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.
-
- Skilled Nursing Facility
- Danville, KY
- NPI 1790594182
BTF Ky Holdings LLC, Epky Trust, Hiky Trust, Ky 10 SNF Operations Holdings LLC, Ky10 SNF Opco Manager LLC, Lion Ky Holdings LLC, Siky Trust, Ssky Trust
-
- Skilled Nursing Facility
- Lexington, KY
- NPI 1477364784
BTF Ky Holdings LLC, Epky Trust, Hiky Trust, Lion Ky Holdings LLC, Siky Trust, Ssky Trust
-
- Skilled Nursing Facility
- Louisville, KY
- NPI 1538978929
Ky 10 SNF Operations Holdings LLC, Ky10 SNF Opco Manager LLC
-
- Skilled Nursing Facility
- Kuttawa, KY
- NPI 1336958727
Ky 10 SNF Operations Holdings LLC, Ky10 SNF Opco Manager LLC
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Internal Medicine Physician
- Louisville, KY
- NPI 1891749305
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2024; 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.