Orchard Grove Specialty Care Center LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

2306 Issued in CT

Legal business name

ORCHARD GROVE SPECIALTY CARE CENTER LLC

Practice address

5 Richard Brown Drive
Uncasville, CT 06382

Phone

(860) 848-8466

Fax

(860) 848-7456

NPI assigned

Dec 4, 2006

Last updated

Apr 1, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Mark Hambley

Title

Cfo

Phone

(860) 678-9755

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CT

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1205994480. Details of each certification follow.

• CCN 075438 Skilled nursing facility · Active · Details

Skilled nursing facility certification: CCN 075438

Legal name

ORCHARD GROVE SPECIALTY CARE CENTER LLC

Doing business as

APPLE REHAB UNCASVILLE

Certification status

Active

Provider type (POS)

Nursing home – SNF/NF dual certification

Participating since

Dec 30, 2004

Last certification

Mar 14, 2024

Beds

130

Ownership / control type

Corporation

Multi-facility organization

APPLE REHAB

Organization structure

CorporationProprietary

Incorporated

Jul 23, 2004 in CT

Enrollment address

5 Richard Brown Dr
Uncasville, CT 06382-1141

Nursing home name

APPLE REHAB UNCASVILLE

Affiliated entity

APPLE REHAB

Listed as

Apple Rehab UncasvilleCCN 075438 · All quality measures

Overall star rating

2 of 5

Health inspections

2 of 5

Staffing

3 of 5

Quality measures

2 of 5

Type

Medicare and Medicaid

Ownership

For profit - Corporation

Certified

Dec 30, 2004

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

130115.1 residents per day on average

Chain

Apple Rehab20 facilities in the chain

Penalties (3 years)

1Fines totaling $16,065

Processed by Care Compare on Aug 1, 2026.

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

CLIA laboratory certificates

Tax ID family

Orchard Grove Specialty Care Center2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Orchard Grove Specialty Care Center

  • Nursing Facility/Intermediate Care Facility
  • Uncasville, CT
  • NPI 1598833725
  NPD tax ID

All disclosed owners & managing parties 3

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

Affiliated clinicians 2

Clinicians who list this facility as an affiliation in Medicare Care Compare.

• Vikram Rao, M.D.

  • Internal Medicine Physician
  • West Haven, CT
  • NPI 1427439249

  Nursing home

  Care Compare affiliation
• Kevin M Tharakan, MD

  • Family Medicine Physician
  • Guilford, CT
  • NPI 1386222636

  Nursing home

  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1165190400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1427846400000",
    "number": "1205994480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 RICHARD BROWN DRIVE",
            "city": "UNCASVILLE",
            "state": "CT",
            "postal_code": "06382",
            "telephone_number": "860-848-8466",
            "fax_number": "860-848-7456"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 RICHARD BROWN DRIVE",
            "city": "UNCASVILLE",
            "state": "CT",
            "postal_code": "06382",
            "telephone_number": "860-848-8466",
            "fax_number": "860-848-7456"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORCHARD GROVE SPECIALTY CARE CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-04",
        "last_updated": "2015-04-01",
        "status": "A",
        "authorized_official_last_name": "HAMBLEY",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "860-678-9755",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "CT",
            "license": "2306",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0021064",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jeremy Norman, L, AT
• Taylor O'Neill
• Samantha Oldman
• Brittany Marie Openshaw
• Orchard Grove Specialty Care Center
• Nicole Eddy Ortiz, MSN, APRN, FNP-BC
• Carl Jay Ousley, SUBIDC
• Grace Park
• Nehaben Patel
• Victor Paul, OD

• Skilled Nursing Facility in Uncasville, CT
• Providers in Uncasville, CT by specialty
• Skilled Nursing Facility in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2015; 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.

Verify at the official NPI Registry.