Hammons Avenue Operating LLC
Organization Active NPI Skilled Nursing Facility · Berryville, AR
NPI 1306547740 · NPPES record last updated Jan 25, 2024
Key facts
- NPI
- 1306547740
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Skilled Nursing Facility 314000000X
- Legal business name
- HAMMONS AVENUE OPERATING LLC
- Practice address
- 500 Hammons Ave
Berryville, AR 72616-4300 - Phone
- (870) 423-6966
- NPI assigned
- Mar 13, 2023
- Organization subpart
- No
Authorized official
- Name
- Yisroel Ganz
- Title
- Director
- Phone
- (732) 366-5705
Owners & managing parties with NPI records 2
Facilities with the same owner 22
Affiliated clinicians 1
-
Richard B Chitsey, M.D.
Medicare Care Compare: Nursing home
- Listed as
- The Blossoms at Berryville Rehab & Nursing Center
- Overall star rating
- ★☆☆☆☆ 1 of 5
- Health inspections
- ★☆☆☆☆ 1 of 5
- Staffing
- ★☆☆☆☆ 1 of 5
- Quality measures
- ★★★★☆ 4 of 5
- Type
- Medicare and Medicaid
- Ownership
- For profit - Limited Liability company
- Certified
- Nov 1, 1995
- Medicare certification status
- Active
- Certified beds
- 114 · 66.9 residents per day on average
- Chain
- The Blossoms Rehab & Nursing Center
- Penalties (3 years)
- 2 · fines totaling $22,880
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AR
Skilled nursing facility certification: CCN 045295
- Legal name
- HAMMONS AVENUE OPERATING LLC
- Doing business as
- THE BLOSSOMS AT BERRYVILLE REHAB & NURSING CENTER
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Nov 1, 1995
- Last certification
- Aug 8, 2024
- Beds
- 114
- Ownership / control type
- Limited Liability Corporation
- Multi-facility organization
- Oasis
- Organization structure
- LLC · Proprietary
- Incorporated
- Feb 28, 2023 in AR
- Enrollment address
- 500 Hammons Ave
Berryville, AR 72616-4300 - Nursing home name
- THE BLOSSOMS AT BERRYVILLE REHAB & NURSING CENTER
- Affiliated entity
- THE BLOSSOMS REHAB & NURSING CENTER
All disclosed owners & managing parties 17
| Name | Role | Since | Share |
|---|---|---|---|
| |
Adp of the SNF | Apr 5, 2023 | |
| |
Adp of the SNF | Apr 5, 2023 | |
| |
Adp of the SNF | Apr 5, 2023 | |
| Matisyohu Herzka |
5% Or Greater Indirect Ownership Interest | Apr 5, 2023 | 33.33% |
| Sisah Staffing Solutions LLC |
Operational/Managerial Control | Apr 5, 2023 | |
| Adp of the SNF | Apr 5, 2023 | ||
| Aks Ar Opco LLC |
5% Or Greater Indirect Ownership Interest | Apr 5, 2023 | 33.34% |
| Abraham Schreiber |
5% Or Greater Indirect Ownership Interest | Apr 5, 2023 | 33.34% |
| Missouri LTC Pharmacy LLC |
Adp of the SNF | Apr 1, 2023 | |
| Jason L Ketcher |
Operational/Managerial Control | Apr 1, 2023 | |
| Adp of the SNF | Apr 5, 2023 | ||
| Diamond Opco Holding LLC |
5% Or Greater Direct Ownership Interest | Apr 1, 2023 | 100% |
| MH Ar Opco LLC |
5% Or Greater Indirect Ownership Interest | Apr 5, 2023 | 33.33% |
| ZCS Ar Opco LLC |
5% Or Greater Indirect Ownership Interest | Apr 5, 2023 | 33.33% |
| Oasis Health Care Group, LLC |
Operational/Managerial Control | Apr 5, 2023 | |
| Adp of the SNF | Apr 5, 2023 | ||
| Tammy L Romero |
Operational/Managerial Control | Apr 5, 2023 | |
| Adp of the SNF | Apr 5, 2023 | ||
| Shlomo Z Scheinbaum |
5% Or Greater Indirect Ownership Interest |
Apr 1, 2023 | 33.33% |
| Operational/Managerial Control | Apr 1, 2023 | ||
| Managing Control - Governing Body |
Apr 1, 2023 | ||
| Adp of the SNF | Apr 1, 2023 | ||
| |
Adp of the SNF | Apr 5, 2023 | |
| |
Adp of the SNF | Mar 15, 2021 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20240905001354 | AR | Part a Provider - Skilled Nursing Facility | 8426598442 | Practice locations: Berryville, AR |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | Yes |
Addresses
Primary practice location
500 Hammons Ave
Berryville, AR 72616-4300
Mailing address
1999 Cedarbridge Ave Ste 3B
Lakewood, NJ 08701-6915
Phone (732) 366-5705
Other providers in Berryville, AR
- Elizabeth Gray
- Jasmine Griffis
- GWL Inc
- GWL Inc
- Brandy Hall
- Kevin Hampton
- Elizabeth Hannum
- Harvest Assembly Inc.
- Healthy Life Chiropractic Inc
- Rebekah Hearn
All providers in Berryville, AR · Skilled Nursing Facility in Arkansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 25, 2024. 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.