Menifee Meadows Nursing & Rehab LLC
Organization Active NPI Skilled Nursing Facility · Frenchburg, KY
NPI 1295620847 · NPPES record last updated Jun 12, 2025
Key facts
- NPI
- 1295620847
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Skilled Nursing Facility 314000000X
- Legal business name
- MENIFEE MEADOWS NURSING & REHAB LLC
- Practice address
- 195 Berryman Rd
Frenchburg, KY 40322-8496 - Phone
- (606) 768-9001
- Fax
- (606) 768-9005
- NPI assigned
- Jun 12, 2025
- Organization subpart
- No
Authorized official
- Name
- Bryon D Womack
- Title
- Sole Member
- Phone
- (828) 334-5323
Owners & managing parties with NPI records 1
Facilities with the same owner 2
Affiliated clinicians 2
-
Taufik Kassis, MD
Medicare Care Compare: Nursing home
- Listed as
- Menifee Meadows Nursing & Rehab LLC
- Overall star rating
- ★★★☆☆ 3 of 5
- Health inspections
- ★★★★☆ 4 of 5
- Staffing
- ★★★☆☆ 3 of 5
- Quality measures
- ★☆☆☆☆ 1 of 5
- Type
- Medicare and Medicaid
- Ownership
- For profit - Limited Liability company
- Certified
- May 14, 1996
- Medicare certification status
- Active
- Certified beds
- 60 · 48.2 residents per day on average
- Chain
- Bao Opco Holdings
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 18D0932594 | Menifee Meadows Nursing & Rehab LLC | Certificate of waiver | Aug 24, 2027 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in KY
Skilled nursing facility certification: CCN 185423
- Legal name
- MENIFEE MEADOWS NURSING & REHAB LLC
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- May 14, 1996
- Last certification
- Dec 20, 2024
- Beds
- 60
- Ownership / control type
- Limited Liability Corporation
- Organization structure
- LLC · Proprietary
- Enrollment address
- 195 Berryman Rd
Frenchburg, KY 40322-8496 - Nursing home name
- MENIFEE MEADOWS NURSING & REHAB LLC
- Affiliated entity
- BAO OPCO HOLDINGS
All disclosed owners & managing parties 18
| Name | Role | Since | Share |
|---|---|---|---|
| Timothy Quinn |
Adp of the SNF | Jun 16, 2025 | |
| Evolve Therapy Services LLC |
Adp of the SNF | Jun 16, 2025 | |
| Grady Womack |
Adp of the SNF | Jun 16, 2025 | |
| Bryon Womack |
5% Or Greater Indirect Ownership Interest | Jun 16, 2025 | 75% |
| Operational/Managerial Control | Jun 16, 2025 | ||
| Managing Control - Governing Body |
Jun 16, 2025 | ||
| Adp of the SNF | Jun 16, 2025 | ||
| Agtl Holdings, LLC |
Adp of the SNF | Jun 16, 2025 | |
| Geraldine Webb |
Operational/Managerial Control | Jun 16, 2025 | |
| Adp of the SNF | Jun 16, 2025 | ||
| Lyle Deitch |
Adp of the SNF | Jun 16, 2025 | |
| Zahid Kothari |
Operational/Managerial Control | Jun 16, 2025 | |
| Adp of the SNF | Jun 16, 2025 | ||
| Ashley Smithey |
5% Or Greater Indirect Ownership Interest |
Jun 16, 2025 | |
| Operational/Managerial Control | Jun 16, 2025 | ||
| Managing Control - Governing Body |
Jun 16, 2025 | ||
| Adp of the SNF | Jun 16, 2025 | ||
| Randy Smithey |
Operational/Managerial Control | Jun 16, 2025 | |
| Adp of the SNF | Jun 16, 2025 | ||
| Brigitte D King |
Operational/Managerial Control | Jun 16, 2025 | |
| Adp of the SNF | Jun 16, 2025 | ||
| Adam Long |
Adp of the SNF | Jun 16, 2025 | |
| Bao Opco Holdings LLC |
5% Or Greater Direct Ownership Interest | Jun 16, 2025 | 100% |
| Operational/Managerial Control | Jun 16, 2025 | ||
| Lisa Bebie |
Adp of the SNF | Jun 16, 2025 | |
| Rise SNF Management LLC |
Operational/Managerial Control | Jun 16, 2025 | |
| Adp of the SNF | Jun 16, 2025 | ||
| Berryman Propco, LLC |
Adp of the SNF | Jun 16, 2025 | |
| Ba Propco Holdings, LLC |
Adp of the SNF | Jun 16, 2025 | |
| Amber Denny |
Adp of the SNF | Jun 16, 2025 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20251015003201 | KY | Part a Provider - Skilled Nursing Facility | 7517454242 | Practice locations: Frenchburg, KY |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | Yes |
Addresses
Primary practice location
195 Berryman Rd
Frenchburg, KY 40322-8496
Mailing address
PO Box 1667
Hickory, NC 28603-1667
Phone (828) 324-8898
Other providers in Frenchburg, KY
- Menifee Co High Middle School
- Menifee County Ambulance Taxing District
- Menifee County Board of Education
- Menifee County Fiscal Court
- Menifee County Nursing Home Corporation
- Karen Metler
- Morgan Morris
- Crystal P Patrick
- Breanna M Rhodes
- Victoria Lavonne Sain-Ingle
All providers in Frenchburg, KY · Skilled Nursing Facility in Kentucky
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 12, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.