Active NPI
Church Hill TN Opco LLC
- Skilled Nursing Facility
- Church Hill, TN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- Legal business name
- CHURCH HILL TN OPCO LLC
- Practice address
- 701 W Main Blvd
Church Hill, TN 37642-3915 - Phone
- (423) 357-7178
- NPI assigned
- Mar 22, 2021
- Last updated
- Feb 7, 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
- David Herskowitz
- Title
- Manager
- Phone
- (212) 444-1991
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | NU | Primary |
Addresses
Primary practice location
701 W Main Blvd
Church Hill, TN 37642-3915
Mailing address
1449 37TH St Ste 605
Brooklyn, NY 11218-4382
Phone (646) 649-0478
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TN
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20211129001078 | TN | Part A Provider - Skilled Nursing Facility | 4082012729 | Practice locations: Church Hill, TN |
NPI to CCN mapping 1
The Medicare certification numbers (CCNs) connected to NPI 1154907079. Details of each certification follow.
Skilled nursing facility certification: CCN 445237
- Legal name
- CHURCH HILL TN OPCO LLC
- Doing business as
- CHURCH HILL POST-ACUTE AND REHABILITATION CENTER
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Sep 23, 1989
- Last certification
- Nov 18, 2024
- Beds
- 124
- Ownership / control type
- Limited Liability Corporation
- Organization structure
- LLC
- Enrollment address
- 701 W Main Blvd
Church Hill, TN 37642-3915 - Nursing home name
- CHURCH HILL POST-ACUTE AND REHABILITATION CENTER
- Affiliated entity
- PLAINVIEW HEALTHCARE PARTNERS
Care Compare: Nursing home
Medicare Care Compare- Listed as
- Church Hill Post-Acute and Rehabilitation Center
- Type
- Medicare and Medicaid
- Ownership
- For profit - Limited Liability company
- Certified
- Sep 23, 1989
- Medicare certification status
- Active
- Certified beds
- 124
- Chain
- Plainview Healthcare Partners
- Special focus status
- SFF
- Penalties (3 years)
- 2
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 44D0859568 | Church Hill TN Opco LLC | Certificate of waiver | Aug 31, 2026 |
National Provider Directory
National Provider DirectoryOwnership & related parties
All disclosed owners & managing parties 6
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 |
|---|---|---|---|
| David Herskowitz | 5% Or Greater Indirect Ownership Interest | Jun 1, 2021 | 20% |
| Operational/Managerial Control | Jun 1, 2021 | ||
| Adp of the SNF | Jun 1, 2021 | ||
| Indirect Ownership Interest | Jun 1, 2021 | 20% | |
| Isaac Moskowitz | Indirect Ownership Interest | Jun 1, 2021 | 39% |
| Jeffrey Arem | Indirect Ownership Interest | Jun 1, 2021 | 39% |
| Mary Stevenson | Operational/Managerial Control | Feb 17, 2025 | |
| Adp of the SNF | Feb 17, 2025 | ||
| Juanchichos T Ventura | Operational/Managerial Control | Jun 1, 2021 | |
| Adp of the SNF | Jun 1, 2021 | ||
| Aaron Kasper | Indirect Ownership Interest | Jun 1, 2021 | 2% |
Owners & managing parties with NPI records 1
Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.
-
- Family Medicine Physician
- Hawthorne, NV
- NPI 1205998366
Adp of the SNF, Operational/Managerial 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, and the practitioner matching its NPPES authorized official.
-
- Family Medicine Physician
- Hawthorne, NV
- NPI 1205998366
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": "1616371200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1675728000000",
"number": "1154907079",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1449 37TH ST STE 605",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112184382",
"telephone_number": "646-649-0478"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "701 W MAIN BLVD",
"city": "CHURCH HILL",
"state": "TN",
"postal_code": "376423915",
"telephone_number": "423-357-7178"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "CHURCH HILL TN OPCO LLC",
"organizational_subpart": "NO",
"enumeration_date": "2021-03-22",
"last_updated": "2023-02-07",
"certification_date": "2023-02-07",
"status": "A",
"authorized_official_last_name": "HERSKOWITZ",
"authorized_official_first_name": "DAVID",
"authorized_official_title_or_position": "MANAGER",
"authorized_official_telephone_number": "212-444-1991"
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Church Hill, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 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.