NPIMap

Organization Active NPI

Williamsburg SNF Operations LLC

  • Skilled Nursing Facility
  • Williamsburg, VA
National Provider Identifier
1225753700
Registry record updated Oct 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
WILLIAMSBURG SNF OPERATIONS LLC
Practice address
1235 S Mount Vernon Ave
Williamsburg, VA 23185-2835
Phone
(757) 229-4121
NPI assigned
Oct 7, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2022

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

Authorized official

Name
Joseph Lieberman
Title
Vice President of Procurement
Phone
(646) 275-4510

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

1235 S Mount Vernon Ave
Williamsburg, VA 23185-2835

Mailing address

1235 S Mount Vernon Ave
Williamsburg, VA 23185-2835
Phone (757) 229-4121

Other names 1

  • Williamsburg Post Acute & Rehabilitation Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230126000342 VA Part A Provider - Skilled Nursing Facility 2264803436 Practice locations: Williamsburg, VA

Skilled nursing facility certification: CCN 495235

Legal name
WILLIAMSBURG SNF OPERATIONS LLC
Doing business as
WILLIAMSBURG POST ACUTE & REHABILITATION
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Apr 17, 1991
Last certification
Oct 28, 2024
Beds
130
Ownership / control type
Limited Liability Corporation
Multi-facility organization
Hill Valley Healthcare
Most recent change of ownership
Dec 1, 2022
Organization structure
LLCProprietary
Incorporated
Jul 21, 2022 in NV
Enrollment address
1235 S Mount Vernon Ave
Williamsburg, VA 23185-2835
Nursing home name
WILLIAMSBURG POST ACUTE & REHABILITATION
Affiliated entity
HILL VALLEY HEALTHCARE

Care Compare: Nursing home

Medicare Care Compare
Listed as
Williamsburg Post Acute & RehabilitationCCN 495235
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
For profit - Limited Liability company
Certified
Apr 17, 1991
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
13095.4 residents per day on average
Chain
Hill Valley Healthcare43 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
49D0675539Williamsburg Post Acute & Rehabilitation1235 S Mount Vernon Avenue, Williamsburg, VA 23185Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 7

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

NameRoleSinceShare
Sabrina 1818 Holdings LLC Organization, Flushing, NY LLC 5% Or Greater Indirect Ownership Interest Dec 1, 2022 48.75%
VA 6 SNF Operations Holdings LLC Organization, Woodmere, NY LLC 5% Or Greater Direct Ownership Interest Dec 1, 2022 100%
Saessy Irrevocable Trust Organization, Cleveland, OH 5% Or Greater Indirect Ownership Interest Dec 1, 2022 46.36%
Shimon Idels Individual Corporate OfficerAuthorized Individual Dec 1, 2022
Tatiriq Irrevocable Trust Organization, Flushing, NY 5% Or Greater Indirect Ownership Interest Dec 1, 2022 46.36%
Lion 26 Holdings LLC Organization, Flushing, NY LLC 5% Or Greater Indirect Ownership Interest Dec 1, 2022 48.75%
Charles E. Phillips Individual W-2 Managing EmployeeAdministrator Dec 1, 2022

Facilities with the same owner 47

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

View all 47

Practitioners & affiliated clinicians

Affiliated clinicians 3

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": "1665100800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1665100800000",
    "number": "1225753700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1235 S MOUNT VERNON AVE",
            "city": "WILLIAMSBURG",
            "state": "VA",
            "postal_code": "231852835",
            "telephone_number": "757-229-4121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1235 S MOUNT VERNON AVE",
            "city": "WILLIAMSBURG",
            "state": "VA",
            "postal_code": "231852835",
            "telephone_number": "757-229-4121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLIAMSBURG SNF OPERATIONS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-07",
        "last_updated": "2022-10-07",
        "certification_date": "2022-10-07",
        "status": "A",
        "authorized_official_last_name": "LIEBERMAN",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_title_or_position": "VICE PRESIDENT OF PROCUREMENT",
        "authorized_official_telephone_number": "646-275-4510"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Williamsburg Post Acute & Rehabilitation",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Williamsburg, VA

Sources for this page

Verify at the official NPI Registry.