NPIMap

Organization Active NPI

South Hill VA Opco LLC

Doing business as Twin Lakes Rehabilitation and Nursing

  • Skilled Nursing Facility
  • South Hill, VA
National Provider Identifier
1205655206
Registry record updated Jan 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
SOUTH HILL VA OPCO LLC
Doing business as
Twin Lakes Rehabilitation and Nursing
Practice address
125 Buena Vista Cir
South Hill, VA 23970-1431
Phone
(434) 447-3151
NPI assigned
Oct 7, 2024
Last updated
Jan 15, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2025

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

Authorized official

Name
Akiva Shapiro
Title
Coo
Phone
(201) 581-6622

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X NU Primary

Addresses

Primary practice location

125 Buena Vista Cir
South Hill, VA 23970-1431

Mailing address

125 Buena Vista Cir
South Hill, VA 23970-1431

Other names 1

  • Twin Lakes Rehabilitation and Nursing Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250926003645 VA Part A Provider - Skilled Nursing Facility 4183129364 Practice locations: South Hill, VA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1205655206. Details of each certification follow.

Skilled nursing facility certification: CCN 495177

Legal name
SOUTH HILL VA OPCO LLC
Doing business as
TWIN LAKES REHABILITATION AND NURSING
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Oct 14, 1987
Last certification
May 3, 2023
Beds
140
Ownership / control type
Nonprofit Corporation
Multi-facility organization
VCU Health SYstem Authority
Most recent change of ownership
Apr 1, 2025
Organization structure
LLCProprietary
Enrollment address
125 Buena Vista Cir
South Hill, VA 23970-1431
Nursing home name
TWIN LAKES REHABILITATION AND NURSING
Affiliated entity
EASTERN HEALTHCARE GROUP

Care Compare: Nursing home

Medicare Care Compare
Listed as
Twin Lakes Rehabilitation and NursingCCN 495177 · All quality measures
Overall star rating
3 of 5
Health inspections
4 of 5
Staffing
1 of 5
Quality measures
3 of 5
Type
Medicare and Medicaid
Ownership
Non profit - Corporation
Certified
Oct 14, 1987
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
14097.8 residents per day on average
Chain
Eastern Healthcare Group18 facilities in the chain

Processed by Care Compare on Aug 1, 2026.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
49D2131512South Hill VA Opco LLC125 Buena Vista Circle, South Hill, VA 23970Certificate of waiverMay 30, 2027

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 14

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

NameRoleSinceShare
A&J Pomona Enterprises LLC Organization, Clifton, NJ LLC, For-profit, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Apr 1, 2025 10%
Adp of the SNF Apr 1, 2025
Lyam Eastern Holdco LLC Organization, Clifton, NJ LLC, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Apr 1, 2025 45%
Adp of the SNF Apr 1, 2025
Bankwell Bank Organization, New Canaan, CT Corporation, Financial institution, For-profit, Owned by another organization or individual 5% Or Greater Security Interest Apr 1, 2025 85%
VA SNF Operations Holdings 5 LLC Organization, Clifton, NJ LLC, Holding company, For-profit, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Apr 1, 2025 100%
Shondel Samuels Individual Managing Control - Governing BodyAdministrator Apr 1, 2025
Adp of the SNF Jul 18, 2025
Lyam Family Trust Organization, Clifton, NJ 5% Or Greater Indirect Ownership Interest Apr 1, 2025 45%
Adp of the SNF Apr 1, 2025
Ydi Irrevocable Trust Organization, Clifton, NJ 5% Or Greater Indirect Ownership Interest Apr 1, 2025 45%
Adp of the SNF Apr 1, 2025
Christopher J Ackerman Individual Adp of the SNF Jul 18, 2025
Ydi Eastern Holdco LLC Organization, Clifton, NJ LLC, Holding company, For-profit, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Apr 1, 2025 45%
Adp of the SNF Apr 1, 2025
Akiva Shapiro Individual Corporate OfficerChief Operations Officer Apr 1, 2025
Managing Control - Governing BodyChief Operations Officer Apr 1, 2025
Yehuda Gittleson Individual Corporate OfficerChief Financial Officer Apr 1, 2025
Operational/Managerial Control Apr 1, 2025
Managing Control - Governing BodyChief Financial Officer Apr 1, 2025
VA SNF Master Consulting LLC Organization, Clifton, NJ LLC, For-profit Operational/Managerial Control Apr 1, 2025
Adp of the SNF Jul 18, 2025
South Hill VA Propco LLC Organization, Clifton, NJ LLC Adp of the SNF Apr 1, 2025
VA SNF Realty Holdings 5 LLC Organization, Clifton, NJ LLC Adp of the SNF Apr 1, 2025

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 17

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

View all 17

Practitioners & affiliated clinicians

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": "1728259200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736899200000",
    "number": "1205655206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 BUENA VISTA CIR",
            "city": "SOUTH HILL",
            "state": "VA",
            "postal_code": "239701431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 BUENA VISTA CIR",
            "city": "SOUTH HILL",
            "state": "VA",
            "postal_code": "239701431",
            "telephone_number": "434-447-3151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH HILL VA OPCO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-10-07",
        "last_updated": "2025-01-15",
        "certification_date": "2025-01-15",
        "status": "A",
        "authorized_official_last_name": "SHAPIRO",
        "authorized_official_first_name": "AKIVA",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "201-581-6622"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Twin Lakes Rehabilitation and Nursing",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in South Hill, VA

Sources for this page

Verify at the official NPI Registry.