NPIMap

Organization Active NPI

Brookneal Life Care Corp

  • Skilled Nursing Facility
  • Brookneal, VA
National Provider Identifier
1295725455
Registry record updated Nov 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
NH2571 Issued in VA
Legal business name
BROOKNEAL LIFE CARE CORP
Practice address
633 Cook Ave
Brookneal, VA 24528-1470
Phone
(434) 376-3740
Fax
(434) 376-3776
NPI assigned
Oct 27, 2005
Last updated
Nov 25, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 25, 2024

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 NH2571 VA Primary

Addresses

Primary practice location

633 Cook Ave
Brookneal, VA 24528-1470

Mailing address

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

Other identifiers 3

IdentifierTypeStateIssuer
4952421MedicaidVA
227237OtherVAANTHEM BCBS HMO PPO ID
608695300OtherVAFEDERAL BLACK LUNG ID

Other names 1

  • Heritage Hall Brookneal Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060203000398 VA Part A Provider - Skilled Nursing Facility 4688695349 Practice locations: Brookneal, VA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1295725455. Details of each certification follow.

Skilled nursing facility certification: CCN 495242

Legal name
BROOKNEAL LIFE CARE CORP
Doing business as
HERITAGE HALL BROOKNEAL
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
May 29, 1991
Last certification
Jul 31, 2024
Beds
60
Ownership / control type
Corporation
Multi-facility organization
American Healthcare, LLC
Organization structure
CorporationProprietary
Enrollment address
633 Cook Ave
Brookneal, VA 24528-3126
Nursing home name
HERITAGE HALL - BROOKNEAL
Affiliated entity
HERITAGE HALL

Care Compare: Nursing home

Medicare Care Compare
Listed as
Heritage Hall - BrooknealCCN 495242 · All quality measures
Overall star rating
5 of 5
Health inspections
5 of 5
Staffing
2 of 5
Quality measures
4 of 5
Type
Medicare and Medicaid
Ownership
For profit - Corporation
Certified
May 29, 1991
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
6057.3 residents per day on average
Chain
Heritage Hall15 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
49D0694320Heritage Hall - Brookneal633 Cook Avenue, Brookneal, VA 24528Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 12

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
Diane Barksdale Individual Adp of the SNF Mar 20, 2026
Organization, Roanoke, VA Direct Ownership Interest Oct 4, 2024 4.36%
Mazen I Madhoun Individual Adp of the SNF Mar 20, 2026
Robert Cranwell Individual Direct Ownership Interest Oct 4, 2024 2.41%
Cassandra Gallant Individual Corporate Officer Jul 11, 2024
Operational/Managerial Control Jul 11, 2024
C. Richard Cranwell Individual Indirect Ownership Interest Oct 4, 2024 3.13%
Thomas East Individual Corporate OfficerPresident & Ceo Nov 20, 2012 100%
Corporate DirectorPresident & Ceo Nov 20, 2012 50%
Operational/Managerial Control Oct 4, 2024
WCC Third Blind Trust Organization, Roanoke, VA 5% Or Greater Direct Ownership Interest Jul 10, 2020 77.73%
American Healthcare LLC Organization, Roanoke, VA LLC Operational/Managerial Control Nov 22, 2010
Robert Dalton Individual Corporate DirectorTreasurer Oct 4, 2024
Ahc Acquisitions, LLC Organization, Roanoke, VA LLC 5% Or Greater Direct Ownership Interest Jul 10, 2020 12.35%

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

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1130371200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1732492800000",
    "number": "1295725455",
    "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": "633 COOK AVE",
            "city": "BROOKNEAL",
            "state": "VA",
            "postal_code": "245281470",
            "telephone_number": "434-376-3740",
            "fax_number": "434-376-3776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROOKNEAL LIFE CARE CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-27",
        "last_updated": "2024-11-25",
        "certification_date": "2024-11-25",
        "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": "NH2571",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4952421",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS HMO PPO ID",
            "identifier": "227237",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FEDERAL BLACK LUNG ID",
            "identifier": "608695300",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Heritage Hall Brookneal",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Heritage Hall Brookneal",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Brookneal, VA

Sources for this page

Verify at the official NPI Registry.