NPIMap

Organization Active NPI

627 Middleton Road Opco LLC

Doing business as Middleton Oaks Health and Rehabilitation

  • Skilled Nursing Facility
  • Winona, MS
National Provider Identifier
1285442137
Registry record updated Mar 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
627 MIDDLETON ROAD OPCO LLC
Doing business as
Middleton Oaks Health and Rehabilitation
Practice address
627 Middleton Rd
Winona, MS 38967-2021
Phone
(662) 283-1260
Fax
(662) 283-4704
NPI assigned
Dec 24, 2024
Last updated
Mar 10, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2025

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

Authorized official

Name
Tiffany Hoback
Title
Manager
Phone
(770) 698-9040

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

627 Middleton Rd
Winona, MS 38967-2021

Mailing address

627 Middleton Rd
Winona, MS 38967-2021
Phone (662) 283-1260

Other names 1

  • Middleton Oaks Health and Rehabilitation Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://65.196.137.118:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRResponse_Service Other Synergy Healthcare Services

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250728002249 MS Part A Provider - Skilled Nursing Facility 2668989310 Practice locations: Winona, MS

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1285442137. Details of each certification follow.

Skilled nursing facility certification: CCN 255171

Legal name
627 MIDDLETON ROAD OPCO LLC
Doing business as
MIDDLETON OAKS HEALTH AND REHABILITATION
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Mar 1, 1994
Last certification
Mar 27, 2025
Beds
120
Ownership / control type
Corporation
Multi-facility organization
Consulate Healthcare
Organization structure
LLC
Enrollment address
627 Middleton Rd
Winona, MS 38967-2021
Nursing home name
MIDDLETON OAKS HEALTH AND REHABILITATION
Affiliated entity
AVARDIS HEALTH

Care Compare: Nursing home

Medicare Care Compare
Listed as
Middleton Oaks Health and RehabilitationCCN 255171 · All quality measures
Overall star rating
1 of 5
Health inspections
1 of 5
Staffing
3 of 5
Quality measures
2 of 5
Type
Medicare and Medicaid
Ownership
For profit - Corporation
Certified
Mar 1, 1994
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
12095.6 residents per day on average
Chain
Avardis Health38 facilities in the chain
Penalties (3 years)
2Fines totaling $10,868

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
25D0674105627 Middleton Road Opco LLC627 Middleton Rd, Winona, MS 38967Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 20

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

NameRoleSinceShare
FC Encore Winona LLC Organization, Hunt Valley, MD LLC, For-profit, Real estate investment trust (REIT), Owned by another organization or individual 5% Or Greater Security Interest May 1, 2025
Adp of the SNF May 1, 2025
Steven K Rushing Individual Operational/Managerial Control Jun 1, 2025
Adp of the SNF Jun 1, 2025
Art and Soul Holdco LLC Organization, Atlanta, GA LLC, Holding company, For-profit, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest May 1, 2025 100%
Nu C II Irrevocable Trust Organization, New York, NY Holding company, For-profit 5% Or Greater Indirect Ownership Interest May 1, 2025 50%
Organization, Kennett Square, PA LLC, For-profit Adp of the SNF Apr 25, 2025
Jonathan S Matthews Individual Operational/Managerial Control Jun 1, 2025
Adp of the SNF Jun 1, 2025
SNF Care Centers LLC Organization, Atlanta, GA LLC, Holding company, For-profit, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest May 1, 2025 100%
Organization, Orlando, FL Corporation, For-profit Adp of the SNF Apr 18, 2025
SNF MGR LLC Organization, Atlanta, GA LLC, Management services company, For-profit Operational/Managerial Control May 1, 2025
Adp of the SNF Apr 18, 2025
Organization, Woonsocket, RI LLC, For-profit Adp of the SNF Apr 18, 2025
Msop Holdco LLC Organization, Atlanta, GA LLC, Holding company, For-profit, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest May 1, 2025 100%
Zenith Holdco II LLC Organization, Atlanta, GA LLC, Holding company, For-profit, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest May 1, 2025 100%
Mercedes Peeples Individual Operational/Managerial Control May 1, 2025
Adp of the SNF May 1, 2025
John Thomas Individual Operational/Managerial Control May 1, 2025
Managing Control - Governing Body May 1, 2025
Adp of the SNF May 1, 2025
Tiffany Hoback Individual Operational/Managerial Control May 1, 2025
Managing Control - Governing Body May 1, 2025
Adp of the SNF May 1, 2025
Zenith Holdco LLC Organization, Atlanta, GA LLC, Holding company, For-profit, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest May 1, 2025 100%
Organization, Atlanta, GA LLC, For-profit Adp of the SNF Apr 18, 2025
Tequilla Jones Individual Operational/Managerial Control May 1, 2025
Adp of the SNF May 1, 2025
Nu C Irrevocable Trust Organization, New York, NY Holding company, For-profit 5% Or Greater Indirect Ownership Interest May 1, 2025 50%
Winona Parentco LLC Organization, Atlanta, GA LLC, Holding company, For-profit, Owned by another organization or individual 5% Or Greater Direct Ownership Interest May 1, 2025 100%

Owners & managing parties with NPI records 2

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

Facilities with the same owner 42

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

View all 42

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

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": "1734998400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1741564800000",
    "number": "1285442137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "627 MIDDLETON RD",
            "city": "WINONA",
            "state": "MS",
            "postal_code": "389672021",
            "telephone_number": "662-283-1260",
            "fax_number": "662-283-4704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "627 MIDDLETON RD",
            "city": "WINONA",
            "state": "MS",
            "postal_code": "389672021",
            "telephone_number": "662-283-1260",
            "fax_number": "662-283-4704"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "627 MIDDLETON ROAD OPCO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-12-24",
        "last_updated": "2025-03-10",
        "certification_date": "2025-03-10",
        "status": "A",
        "authorized_official_last_name": "HOBACK",
        "authorized_official_first_name": "TIFFANY",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "770-698-9040"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://65.196.137.118:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRResponse_Service",
            "affiliation": "Y",
            "endpointDescription": "urn:oid:2.16.840.1.113883.3.5042",
            "affiliationName": "Synergy Healthcare Services",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "850 Concourse Pkwy S Ste 250",
            "city": "Maitland",
            "state": "FL",
            "country_code": "US",
            "postal_code": "327516155",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Middleton Oaks Health and Rehabilitation",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Winona, MS

Sources for this page

Verify at the official NPI Registry.