NPIMap

Organization Active NPI

Patrick Henry Hospital, Inc.

Doing business as Riverside Convalescent Center, Mathews

  • Nursing Facility/Intermediate Care Facility
  • Mathews, VA
National Provider Identifier
1255448379
Registry record updated Nov 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nursing Facility/Intermediate Care FacilityTaxonomy code 313M00000X
License
49E215 Issued in VA
Legal business name
PATRICK HENRY HOSPITAL, INC.
Doing business as
Riverside Convalescent Center, Mathews
Practice address
603 Main St.
Mathews, VA 23109
Phone
(804) 725-9443
Fax
(804) 725-3184
NPI assigned
Aug 24, 2006
Last updated
Nov 30, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2021

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

Authorized official

Name
Mr. Walter W Austin
Title
Cfo
Phone
(757) 875-7846

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Nursing Facility/Intermediate Care Facility 313M00000X 49E215 VA Primary
Skilled Nursing Facility 314000000X
Nursing Facility Supplies (DME) 332BN1400X 49E215 VA
Parenteral & Enteral Nutrition Supplies (DME) 332BP3500X 49E215 VA

Addresses

Primary practice location

603 Main St.
Mathews, VA 23109

Mailing address

608 Denbigh Blvd
Suite 600
Newport News, VA 23608-4410
Phone (757) 875-2023

Other identifiers 2

IdentifierTypeStateIssuer
004967348MedicaidVA
495429OtherMEDICARE

Other names 1

  • Riverside Convalescent Center, Mathews Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210224002340 VA Part A Provider - Skilled Nursing Facility 0648169425 Practice locations: Mathews, VA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1255448379. Details of each certification follow.

Skilled nursing facility certification: CCN 495429

Legal name
PATRICK HENRY HOSPITAL, INC.
Doing business as
RIVERSIDE LIFELONG HEALTH AND REHABILITATION MATHEWS
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Sep 30, 2021
Last certification
Aug 3, 2023
Beds
60
Ownership / control type
Nonprofit Corporation
Multi-facility organization
Riverside Lifelong Health
Organization structure
CorporationNon-profit
Incorporated
Jul 16, 1948 in VA
Enrollment address
603 Main St
Mathews, VA 23109-2164
Nursing home name
RIVERSIDE LIFELONG HEALTH AND REHABILITATION – MAT
Affiliated entity
RIVERSIDE HEALTH SYSTEM

Other NPIs with the same Medicare PAC ID 3

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Nursing home

Medicare Care Compare
Listed as
Riverside Lifelong Health and Rehabilitation - MCCN 495429 · All quality measures
Overall star rating
4 of 5
Health inspections
4 of 5
Staffing
3 of 5
Quality measures
4 of 5
Type
Medicare and Medicaid
Ownership
Non profit - Corporation
Certified
Sep 30, 2021
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
6057.4 residents per day on average
Chain
Riverside Health System6 facilities in the chain

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory
Tax ID family
Patrick Henry Hospital6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 17

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

NameRoleSinceShare
Walter W Austin Individual Corporate OfficerCfo, Treasurer Jul 2, 2012
Jason Houser Individual Corporate OfficerVP Legal Affairs/Secretary Jan 1, 2019
Michael J Dacey Individual Corporate OfficerPresident/Coo Jan 1, 2019
Riverside Healthcare Association, Inc. Organization, Newport News, VA Corporation, Non-profit 5% Or Greater Direct Ownership Interest May 3, 2010 100%
Joyce J Alewynse Individual Corporate DirectorBoard Member Mar 1, 2022
Kirby Smith Individual Corporate DirectorBoard Member Jun 1, 2008
Joseph F Verser Individual Corporate DirectorBoard Member Mar 1, 2022
Brooke Tiller Individual Corporate DirectorBoard Member Mar 1, 2022
Rector & Visitors of the University of Virginia Organization, Charlottesville, VA Corporation, Non-profit 5% Or Greater Indirect Ownership Interest Jul 10, 2023 5%
Jeanne Zeidler Individual Corporate DirectorBoard Member Jan 1, 2019
Riverside Integrated Services Inc Organization, Newport News, VA Corporation, Non-profit 5% Or Greater Indirect Ownership Interest Jul 10, 2023 95%
Barbara Smith Haywood Individual Corporate DirectorVice Chairman Jan 1, 2016
Linwood Shawn Nelson Individual W-2 Managing EmployeeAvp, Finance/Cfo, LLH Jan 23, 2014
William B Downey Individual Corporate OfficerCeo Jun 1, 2008
Jared L Bates Individual Corporate DirectorBoard Member Mar 1, 2022
Edward Heckler Individual Corporate OfficerPresident, LLH Jan 1, 2019
Conway Smith Individual Corporate DirectorBoard Member - Chairman Jun 1, 2008

Owners & managing parties with NPI records 23

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

View all 23

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Riverside Home HealthWarsaw, VA, CCN 497025B Home health agency 5% Or Greater Direct Ownership Interest (100%) Dec 31, 2020
Riverside HospiceWarsaw, VA, CCN 491554 Hospice 5% Or Greater Direct Ownership Interest Dec 31, 2020

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Facilities with the same owner 23

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

  • Doctors' Hospital of Williamsburg

    dba Riverside Doctors Hospital Williamsburg

    • General Acute Care Hospital
    • Williamsburg, VA
    • NPI 1275893307

    Rector & Visitors of the University of Virginia, Riverside Healthcare Association, Inc., Riverside Integrated Services Inc

    CMS ownership
  • Francis N. Sanders Nursing Home, Inc

    dba Riverside Lifelong Health & Rehabilitation Sanders

    • Nursing Facility/Intermediate Care Facility
    • Gloucester, VA
    • NPI 1356456644

    Rector & Visitors of the University of Virginia, Riverside Healthcare Association, Inc., Riverside Integrated Services Inc

    CMS ownership
  • Patrick Henry Hospital Inc

    dba The Gardens at Warwick Forest

    • Nursing Facility/Intermediate Care Facility
    • Newport News, VA
    • NPI 1013022268

    Riverside Healthcare Association, Inc.

    CMS ownership
  • Patrick Henry Hospital, Inc.

    dba Riverside Convalescent Center, Saluda

    • Nursing Facility/Intermediate Care Facility
    • Saluda, VA
    • NPI 1225143498

    Rector & Visitors of the University of Virginia, Riverside Healthcare Association, Inc., Riverside Integrated Services Inc

    CMS ownership
  • Patrick Henry Hospital, Inc.

    dba Riverside Assisted Living at Smithfield

    • Skilled Nursing Facility
    • Smithfield, VA
    • NPI 1588779193

    Rector & Visitors of the University of Virginia, Riverside Healthcare Association, Inc., Riverside Integrated Services Inc

    CMS ownership
  • Patriots Colony, Inc.

    dba Patriots Colony at Williamsburg

    • Assisted Living Facility
    • Williamsburg, VA
    • NPI 1205945904

    Riverside Healthcare Association, Inc.

    CMS ownership
  • Rector & Visitors of the University of Virginia

    dba UVA Health Sciences Center

    • Psychiatric Hospital Unit
    • Charlottesville, VA
    • NPI 1184731507

    Rector & Visitors of the University of Virginia

    CMS ownership
  • Rector & Visitors of the University of Virginia

    dba Continuum Home Health Care

    • Home Health Agency
    • Charlottesville, VA
    • NPI 1265472286

    Rector & Visitors of the University of Virginia

    CMS ownership
  • Rector & Visitors of the University of Virginia

    dba UVA Health Sciences Center

    • General Acute Care Hospital
    • Charlottesville, VA
    • NPI 1780630608

    Rector & Visitors of the University of Virginia

    CMS ownership
  • Riverside Hospital Inc

    dba Riverside Hospice

    • Community Based Hospice Care Agency
    • Newport News, VA
    • NPI 1326045535

    Rector & Visitors of the University of Virginia, Riverside Healthcare Association, Inc., Riverside Integrated Services Inc

    CMS ownership
  • Riverside Hospital Inc

    dba Riverside Smithfield Hospital

    • General Acute Care Hospital
    • Smithfield, VA
    • NPI 1366259863

    Rector & Visitors of the University of Virginia, Riverside Integrated Services Inc

    CMS ownership
  • Riverside Hospital Inc

    dba Riverside Regional Medical Center

    • General Acute Care Hospital
    • Newport News, VA
    • NPI 1366547747

    Rector & Visitors of the University of Virginia, Riverside Healthcare Association, Inc., Riverside Integrated Services Inc

    CMS ownership
View all 23

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": "1156377600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1638230400000",
    "number": "1255448379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "608 DENBIGH BLVD",
            "address_2": "SUITE 600",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236084410",
            "telephone_number": "757-875-2023",
            "fax_number": "757-875-2016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "603 MAIN ST.",
            "city": "MATHEWS",
            "state": "VA",
            "postal_code": "23109",
            "telephone_number": "804-725-9443",
            "fax_number": "804-725-3184"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PATRICK HENRY HOSPITAL, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-24",
        "last_updated": "2021-11-30",
        "certification_date": "2021-11-30",
        "status": "A",
        "authorized_official_last_name": "AUSTIN",
        "authorized_official_first_name": "WALTER",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "757-875-7846",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": "VA",
            "license": "49E215",
            "primary": true
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332BN1400X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Nursing Facility Supplies",
            "state": "VA",
            "license": "49E215",
            "primary": false
        },
        {
            "code": "332BP3500X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition",
            "state": "VA",
            "license": "49E215",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004967348",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "495429",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Riverside Convalescent Center, Mathews",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Riverside Convalescent Center, Mathews",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mathews, VA

Sources for this page

Verify at the official NPI Registry.