Active NPI
Amherst SNF Operations LLC
Doing business as Fairmont Crossing Health and Rehab Center
- Skilled Nursing Facility
- Amherst, VA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- Legal business name
- AMHERST SNF OPERATIONS LLC
- Doing business as
- Fairmont Crossing Health and Rehab Center
- Practice address
- 173 Brockman Park Dr
Amherst, VA 24521-2583 - Phone
- (434) 946-2850
- NPI assigned
- Aug 4, 2021
- Last updated
- Nov 5, 2021
- 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
- Joseph Lieberman
- Title
- Director of Financial Operations
- Phone
- (516) 855-5504
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | NU | Primary |
Addresses
Primary practice location
173 Brockman Park Dr
Amherst, VA 24521-2583
Mailing address
1007 Broadway
Woodmere, NY 11598-1246
Other names 1
- Fairmont Crossing Health and Rehab Center
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in VA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20220127000778 | VA | Part A Provider - Skilled Nursing Facility | 9931591831 | Practice locations: Amherst, VA |
NPI to CCN mapping 1
The Medicare certification numbers (CCNs) connected to NPI 1174297063. Details of each certification follow.
Skilled nursing facility certification: CCN 495363
- Legal name
- AMHERST SNF OPERATIONS LLC
- Doing business as
- FAIRMONT CROSSING HEALTH AND REHAB CENTER
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Jul 5, 2002
- Last certification
- Jun 2, 2022
- Beds
- 120
- Ownership / control type
- Corporation
- Multi-facility organization
- Hill Valley Healthcare
- Organization structure
- LLC
- Incorporated
- May 11, 2021 in VA
- Enrollment address
- 173 Brockman Park Dr
Amherst, VA 24521-2583 - Nursing home name
- FAIRMONT CROSSING HEALTH AND REHAB CENTER
- Affiliated entity
- HILL VALLEY HEALTHCARE
Care Compare: Nursing home
Medicare Care Compare- Listed as
- Fairmont Crossing Health and Rehab Center
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- For profit - Limited Liability company
- Certified
- Jul 5, 2002
- Medicare certification status
- Active
- Certified beds
- 120
- Chain
- Hill Valley Healthcare
- Penalties (3 years)
- 1
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 |
|---|---|---|---|
| 49D0997395 | Fairmont Crossing Health & Rehab Center | Certificate of waiver | Mar 13, 2028 |
National Provider Directory
National Provider DirectoryOwnership & related parties
All disclosed owners & managing parties 10
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 |
|---|---|---|---|
| Timberlake Operations Holdings LLC | 5% Or Greater Indirect Ownership Interest | Nov 1, 2021 | 100% |
| Sabrina 1818 Holdings LLC | 5% Or Greater Indirect Ownership Interest | Nov 1, 2021 | 47.5% |
| Saessy Irrevocable Trust | 5% Or Greater Indirect Ownership Interest | Nov 1, 2021 | 45.2% |
| Sarah M Wade | W-2 Managing Employee | Nov 1, 2021 | |
| HVH Timberlake Management LLC | Operational/Managerial Control | Nov 1, 2021 | 100% |
| Shimon Idels | Corporate Officer | Nov 1, 2021 | |
| Delilah 2626 Holdings LLC | 5% Or Greater Indirect Ownership Interest | Nov 1, 2021 | 5% |
| Tatiriq Irrevocable Trust | 5% Or Greater Indirect Ownership Interest | Nov 1, 2021 | 45.2% |
| Lion 26 Holdings LLC | 5% Or Greater Indirect Ownership Interest | Nov 1, 2021 | 47.5% |
| Amherst SNF Holdings LLC | 5% Or Greater Direct Ownership Interest | Nov 1, 2021 | 100% |
Facilities with the same owner 47
Facilities that share an organizational owner with 5% or greater ownership or operational control.
-
dba Alexandria Health & Rehabilitation
- Skilled Nursing Facility
- Alexandria, VA
- NPI 1346951761
Lion 26 Holdings LLC, Sabrina 1818 Holdings LLC, Saessy Irrevocable Trust, Tatiriq Irrevocable Trust
-
dba Oakwood Health and Rehab Center
- Skilled Nursing Facility
- Bedford, VA
- NPI 1508530387
Delilah 2626 Holdings LLC, HVH Timberlake Management LLC, Lion 26 Holdings LLC, Sabrina 1818 Holdings LLC, Saessy Irrevocable Trust, Tatiriq Irrevocable Trust, Timberlake Operations Holdings LLC
-
dba Shalom Gardens Health & Rehabilitation
- Skilled Nursing Facility
- Richmond, VA
- NPI 1881388510
Lion 26 Holdings LLC, Sabrina 1818 Holdings LLC, Saessy Irrevocable Trust, Tatiriq Irrevocable Trust
-
dba Blue Ridge Therapy Connection
- Skilled Nursing Facility
- Stuart, VA
- NPI 1013478411
Delilah 2626 Holdings LLC, Lion 26 Holdings LLC, Sabrina 1818 Holdings LLC, Saessy Irrevocable Trust, Tatiriq Irrevocable Trust
-
dba Carlin Springs Health & Rehabilitation
- Skilled Nursing Facility
- Arlington, VA
- NPI 1700597127
Lion 26 Holdings LLC, Sabrina 1818 Holdings LLC, Saessy Irrevocable Trust, Tatiriq Irrevocable Trust
-
dba Guggenheimer Health and Rehab Center
- Skilled Nursing Facility
- Lynchburg, VA
- NPI 1679247563
Delilah 2626 Holdings LLC, HVH Timberlake Management LLC, Lion 26 Holdings LLC, Sabrina 1818 Holdings LLC, Saessy Irrevocable Trust, Tatiriq Irrevocable Trust, Timberlake Operations Holdings LLC
-
dba Evergreen Health and Rehabilitation Center
- Skilled Nursing Facility
- Winchester, VA
- NPI 1487221107
Lion 26 Holdings LLC, Sabrina 1818 Holdings LLC, Saessy Irrevocable Trust, Tatiriq Irrevocable Trust
-
dba Fair Oaks Health & Rehabilitation
- Skilled Nursing Facility
- Fairfax, VA
- NPI 1972214393
Lion 26 Holdings LLC, Sabrina 1818 Holdings LLC, Saessy Irrevocable Trust, Tatiriq Irrevocable Trust
-
dba Oakhurst Health & Rehabilitation
- Skilled Nursing Facility
- Fork Union, VA
- NPI 1194441949
Lion 26 Holdings LLC, Sabrina 1818 Holdings LLC, Saessy Irrevocable Trust, Tatiriq Irrevocable Trust
-
dba Highland Ridge Rehab Center
- Skilled Nursing Facility
- Dublin, VA
- NPI 1679034078
Delilah 2626 Holdings LLC, Lion 26 Holdings LLC, Sabrina 1818 Holdings LLC, Saessy Irrevocable Trust, Tatiriq Irrevocable Trust
-
dba Holly Manor Rehab and Nursing
- Skilled Nursing Facility
- Farmville, VA
- NPI 1235886607
Delilah 2626 Holdings LLC, Lion 26 Holdings LLC, Sabrina 1818 Holdings LLC, Saessy Irrevocable Trust, Tatiriq Irrevocable Trust
-
dba Lakeside Health & Rehabilitation
- Skilled Nursing Facility
- Richmond, VA
- NPI 1427769843
Lion 26 Holdings LLC, Sabrina 1818 Holdings LLC, Saessy Irrevocable Trust, Tatiriq Irrevocable Trust
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1628035200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1636070400000",
"number": "1174297063",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1007 BROADWAY",
"city": "WOODMERE",
"state": "NY",
"postal_code": "115981246"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "173 BROCKMAN PARK DR",
"city": "AMHERST",
"state": "VA",
"postal_code": "245212583",
"telephone_number": "434-946-2850"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "AMHERST SNF OPERATIONS LLC",
"organizational_subpart": "NO",
"enumeration_date": "2021-08-04",
"last_updated": "2021-11-05",
"certification_date": "2021-11-05",
"status": "A",
"authorized_official_last_name": "LIEBERMAN",
"authorized_official_first_name": "JOSEPH",
"authorized_official_title_or_position": "DIRECTOR OF FINANCIAL OPERATIONS",
"authorized_official_telephone_number": "516-855-5504"
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Fairmont Crossing Health and Rehab Center",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Amherst, VA
- Access Family Care Services of Central Virginia, LLC
- Amherst County Board of Supervisors (Amherst County Department of Public Safety)
- Amherst County Public Schools
- Amherst Family Physicians, Inc
- Amherst Physical Therapy LTD
- Martha S Anderson
- Alexandra Nicole Bachman, DO
- Blackberry Ridge, LLC
- Blue Ridge Health Center Inc (Blue Ridge Medical Center - Amherst)
- Lester William Boas III
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2021; 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.