NPIMap

Organization Active NPI

Blacksburg Life Care, LLC

Doing business as Heritage Hall - Blacksburg

  • Skilled Nursing Facility
  • Blacksburg, VA
National Provider Identifier
1265422646
Registry record updated May 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
NH2569 Issued in VA
Legal business name
BLACKSBURG LIFE CARE, LLC
Doing business as
Heritage Hall - Blacksburg
Practice address
3610 S Main St
Blacksburg, VA 24060
Phone
(540) 951-7000
Fax
(540) 951-4109
NPI assigned
Oct 26, 2005
Last updated
May 8, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 8, 2026

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

Authorized official

Name
Cassandra Gallant
Title
Compliance & Privacy Officer
Phone
(540) 774-4263

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X NH2569 VA Primary

Addresses

Primary practice location

3610 S Main St
Blacksburg, VA 24060

Mailing address

3131 Electric Rd
Roanoke, VA 24018-6427
Phone (540) 774-4263

Other identifiers 3

IdentifierTypeStateIssuer
180503OtherVAANTHEM BCBS PROVIDER ID
200515600OtherVAFEDERAL BLACK LUNG
4953568MedicaidVA

Other names 1

  • Heritage Hall - Blacksburg Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180813002357 VA Part A Provider - Skilled Nursing Facility 4880942556 Practice locations: Blacksburg, VA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1265422646. Details of each certification follow.

Skilled nursing facility certification: CCN 495356

Legal name
BLACKSBURG LIFE CARE, LLC
Doing business as
HERITAGE HALL- BLACKSBURG
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Oct 1, 2001
Last certification
Aug 29, 2024
Beds
179
Ownership / control type
Corporation
Organization structure
LLCProprietary
Incorporated
Jan 22, 2018 in VA
Enrollment address
3610 S Main St
Blacksburg, VA 24060-7015
Nursing home name
HERITAGE HALL BLACKSBURG
Affiliated entity
HERITAGE HALL

Care Compare: Nursing home

Medicare Care Compare
Listed as
Heritage Hall BlacksburgCCN 495356 · All quality measures
Overall star rating
4 of 5
Health inspections
4 of 5
Staffing
2 of 5
Quality measures
4 of 5
Type
Medicare and Medicaid
Ownership
For profit - Corporation
Certified
Oct 1, 2001
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
179132.3 residents per day on average
Chain
Heritage Hall15 facilities in the chain

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory
Tax ID family
American Healthcare LLC2 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.

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
William B Hopkins Individual Corporate Director Jul 23, 2010
Alyssa Hamilton Individual Operational/Managerial Control Oct 4, 2024
Adp of the SNF Mar 25, 2026
Brad Dalton Individual Operational/Managerial Control Jul 11, 2024
Benjamin C Davis Individual Adp of the SNF Mar 25, 2026
Cassandra Gallant Individual Corporate OfficerCompliance Officer Jul 11, 2024
Adp of the SNF Jan 7, 2025
Thomas East Individual Corporate Officer Nov 20, 2012
Corporate Director Nov 20, 2012
American Healthcare LLC Organization, Roanoke, VA LLC Operational/Managerial Control Nov 22, 2010

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 14

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

View all 14

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": "1130284800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1778198400000",
    "number": "1265422646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3131 ELECTRIC RD",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240186427",
            "telephone_number": "540-774-4263",
            "fax_number": "540-774-0780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3610 S MAIN ST",
            "city": "BLACKSBURG",
            "state": "VA",
            "postal_code": "24060",
            "telephone_number": "540-951-7000",
            "fax_number": "540-951-4109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLACKSBURG LIFE CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-26",
        "last_updated": "2026-05-08",
        "certification_date": "2026-05-08",
        "status": "A",
        "authorized_official_last_name": "GALLANT",
        "authorized_official_first_name": "CASSANDRA",
        "authorized_official_title_or_position": "COMPLIANCE & PRIVACY OFFICER",
        "authorized_official_telephone_number": "540-774-4263"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "VA",
            "license": "NH2569",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS PROVIDER ID",
            "identifier": "180503",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FEDERAL BLACK LUNG",
            "identifier": "200515600",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4953568",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Heritage Hall - Blacksburg",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Blacksburg, VA

Sources for this page

Verify at the official NPI Registry.