Active NPI
Wat Opco LLC
- Skilled Nursing Facility
- Tolland, CT
National Provider Identifier
1205406162
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- Legal business name
- WAT OPCO LLC
- Practice address
- 26 Shenipsit Lake Rd
Tolland, CT 06084-2332 - Phone
- (860) 872-2999
- NPI assigned
- Jul 1, 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
- Rachel Shakow
- Title
- Authorized Official
- Phone
- (781) 784-6781
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | Primary |
Addresses
Primary practice location
26 Shenipsit Lake Rd
Tolland, CT 06084-2332
Mailing address
26 Shenipsit Lake Rd
Tolland, CT 06084-2332
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CT
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20220127001104 | CT | Part A Provider - Skilled Nursing Facility | 4981096781 | Practice locations: Tolland, CT |
Skilled nursing facility certification: CCN 075382
- Legal name
- WAT OPCO LLC
- Doing business as
- WOODLAKE AT TOLLAND
- Certification status
- Active
- Provider type (POS)
- Nursing home โ SNF/NF dual certification
- Participating since
- Mar 16, 1993
- Last certification
- Mar 26, 2024
- Beds
- 130
- Ownership / control type
- Limited Liability Corporation
- Organization structure
- LLC
- Enrollment address
- 26 Shenipsit Lake Rd
Tolland, CT 06084-2332 - Nursing home name
- WOODLAKE AT TOLLAND
Care Compare: Nursing home
Medicare Care Compare- Listed as
- Woodlake at Tolland
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- For profit - Limited Liability company
- Certified
- Mar 16, 1993
- Medicare certification status
- Active
- Certified beds
- 130
National Provider Directory
National Provider DirectoryOwnership & related parties
All disclosed owners & managing parties 1
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 |
|---|---|---|---|
| Rachel Shakow | 5% Or Greater Direct Ownership Interest | Jul 1, 2021 | 91% |
| Corporate Director | Jul 1, 2021 | ||
| W-2 Managing Employee | Jul 1, 2021 |
Practitioners & affiliated clinicians
Affiliated clinicians 2
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": "1625097600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1625097600000",
"number": "1205406162",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "26 SHENIPSIT LAKE RD",
"city": "TOLLAND",
"state": "CT",
"postal_code": "060842332"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "26 SHENIPSIT LAKE RD",
"city": "TOLLAND",
"state": "CT",
"postal_code": "060842332",
"telephone_number": "860-872-2999"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "WAT OPCO LLC",
"organizational_subpart": "NO",
"enumeration_date": "2021-07-01",
"last_updated": "2021-07-01",
"certification_date": "2021-07-01",
"status": "A",
"authorized_official_last_name": "SHAKOW",
"authorized_official_first_name": "RACHEL",
"authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
"authorized_official_telephone_number": "781-784-6781"
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Tolland, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 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.