Active NPI
Gifford Retirement Community, Inc
Doing business as Menig Nursing Home
- Nursing Facility/Intermediate Care Facility
- Randolph, VT
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nursing Facility/Intermediate Care Facility
- Legal business name
- GIFFORD RETIREMENT COMMUNITY, INC
- Doing business as
- Menig Nursing Home
- Practice address
- 3556 RT 66
Randolph, VT 05060-1318 - Phone
- (802) 728-2125
- Fax
- (802) 728-2143
- NPI assigned
- Jan 30, 2015
- Last updated
- Jan 30, 2015
- Organization subpart
- Yes
- Parent organization
- GIFFORD RETIREMENT COMMUNITY, INC
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Jeffrey C Hebert
- Title
- Chief Financial Officer
- Phone
- (802) 728-2356
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nursing Facility/Intermediate Care Facility | 313M00000X | Primary |
Addresses
Primary practice location
3556 RT 66
Randolph, VT 05060-1318
Mailing address
44 S Main St
PO Box 2000
Randolph, VT 05060-1381
Phone (802) 728-7000
Other names 1
- Menig Nursing Home
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in VT
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20150415000382 | VT | Part A Provider - Skilled Nursing Facility | 4880912252 | Practice locations: Randolph Ctr, VT |
NPI to CCN mapping 1
The Medicare certification numbers (CCNs) connected to NPI 1366832230. Details of each certification follow.
Skilled nursing facility certification: CCN 475058
- Legal name
- GIFFORD RETIREMENT COMMUNITY, INC
- Doing business as
- MENIG NURSING HOME
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- May 1, 2001
- Last certification
- Jul 25, 2024
- Beds
- 30
- Ownership / control type
- Nonprofit Corporation
- Organization structure
- Corporation
- Incorporated
- Aug 12, 2013 in VT
- Enrollment address
- 215 Tom Wicker LN
Randolph Ctr, VT 05061 - Nursing home name
- MENIG NURSING HOME
Care Compare: Nursing home
Medicare Care Compare- Listed as
- Menig Nursing Home
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- Non profit - Corporation
- Certified
- May 1, 2001
- Medicare certification status
- Active
- Certified beds
- 30
- Penalties (3 years)
- 1
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 47D2145534 | Menig Nursing Home | Certificate of waiver | Mar 8, 2028 |
National Provider Directory
National Provider Directory- Part of
- Gifford Retirement Community Inc
Member of 1
Organizations this organization is a member of, according to the National Provider Directory.
Locations
215 Tom Wicker Ln
Randolph Ctr, VT 05061
Phone (802) 728-7800
Ownership & related parties
All disclosed owners & managing parties 16
As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.
| Name | Role | Since | Share |
|---|---|---|---|
| Heather E Impey | Operational/Managerial Control | Jul 28, 2025 | |
| Adp of the SNF | Mar 9, 2026 | ||
| Kathleen Mason | Managing Control - Governing Body | Jan 2, 2025 | |
| Trustee of the SNF | Jan 2, 2025 | ||
| Michael K Costa | Corporate Director | Oct 3, 2024 | |
| Trustee of the SNF | Oct 1, 2024 | ||
| Victor Ribaudo | Managing Control - Governing Body | Jan 2, 2025 | |
| Trustee of the SNF | Jan 2, 2025 | ||
| Cheyenne Holland | Corporate Officer | Aug 19, 2024 | |
| Operational/Managerial Control | Aug 19, 2024 | ||
| Trustee of the SNF | Aug 19, 2024 | ||
| Gifford Health Care Inc | 5% Or Greater Direct Ownership Interest | Aug 12, 2013 | 100% |
| Trustee of the SNF | Aug 12, 2013 | ||
| Adp of the SNF | Aug 12, 2013 | ||
| Direct Ownership Interest | Aug 12, 2013 | 100% | |
| Jeffrey J Nelb | Managing Control - Governing Body | Jan 2, 2025 | |
| Trustee of the SNF | Jan 2, 2025 | ||
| Paul Putney | Managing Control - Governing Body | Jan 2, 2025 | |
| Trustee of the SNF | Jan 2, 2025 | ||
| Kristin Chandler | Managing Control - Governing Body | Jan 2, 2025 | |
| Cindy Rosalbo | Managing Control - Governing Body | Jan 2, 2025 | |
| Trustee of the SNF | Jan 2, 2025 | ||
| Sarah Jackson | Managing Control - Governing Body | Jan 2, 2025 | |
| Trustee of the SNF | Jan 2, 2025 | ||
| Cristine J Maloney | Operational/Managerial Control | Jan 1, 2025 | |
| Adp of the SNF | Mar 9, 2026 | ||
| Morgan Rilling | Managing Control - Governing Body | Jan 2, 2025 | |
| Trustee of the SNF | Jan 2, 2025 | ||
| Jamie Kinnarney | Managing Control - Governing Body | Jan 2, 2025 | |
| Trustee of the SNF | Jan 2, 2025 | ||
| Peter Reed | Managing Control - Governing Body | Jan 2, 2025 | |
| Trustee of the SNF | Jan 2, 2025 | ||
| Emilija O Florance | Managing Control - Governing Body | Jan 2, 2025 | |
| Trustee of the SNF | Jan 2, 2025 |
Owners & managing parties with NPI records 11
Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.
-
- Family Medicine Physician
- Randolph, VT
- NPI 1326434713
Managing Control - Governing Body, Trustee of the SNF
-
- General Practice Physician
- Randolph, VT
- NPI 1013269430
5% Or Greater Direct Ownership Interest, Adp of the SNF, Direct Ownership Interest, Trustee of the SNF
-
dba Twin River Health Center
- Federally Qualified Health Center (FQHC)
- White River Junction, VT
- NPI 1073943999
5% Or Greater Direct Ownership Interest, Adp of the SNF, Direct Ownership Interest, Trustee of the SNF
-
dba Gifford Health Center at Berlin
- Federally Qualified Health Center (FQHC)
- Barre, VT
- NPI 1184054009
5% Or Greater Direct Ownership Interest, Adp of the SNF, Direct Ownership Interest, Trustee of the SNF
-
dba Rochester Health Center
- Federally Qualified Health Center (FQHC)
- Rochester, VT
- NPI 1285064105
5% Or Greater Direct Ownership Interest, Adp of the SNF, Direct Ownership Interest, Trustee of the SNF
-
dba Gifford Primary Care
- Federally Qualified Health Center (FQHC)
- Randolph, VT
- NPI 1326478702
5% Or Greater Direct Ownership Interest, Adp of the SNF, Direct Ownership Interest, Trustee of the SNF
-
dba Chelsea Health Center
- Federally Qualified Health Center (FQHC)
- Chelsea, VT
- NPI 1457781031
5% Or Greater Direct Ownership Interest, Adp of the SNF, Direct Ownership Interest, Trustee of the SNF
-
dba Bethel Health Center
- Federally Qualified Health Center (FQHC)
- Bethel, VT
- NPI 1659701571
5% Or Greater Direct Ownership Interest, Adp of the SNF, Direct Ownership Interest, Trustee of the SNF
-
dba Gifford Pedicatric and Adolescent Medicine
- Federally Qualified Health Center (FQHC)
- Randolph, VT
- NPI 1831782929
5% Or Greater Direct Ownership Interest, Adp of the SNF, Direct Ownership Interest, Trustee of the SNF
-
dba Gifford Health Center at Kingwood
- Federally Qualified Health Center (FQHC)
- Randolph, VT
- NPI 1619427663
5% Or Greater Direct Ownership Interest, Adp of the SNF, Direct Ownership Interest, Trustee of the SNF
-
- Hospice and Palliative Medicine (Internal Medicine) Physician
- Randolph, VT
- NPI 1972787273
Adp of the SNF, Operational/Managerial Control
Practitioners & affiliated clinicians
Practitioners 1
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.
-
- Hospice and Palliative Medicine (Internal Medicine) Physician
- Randolph, VT
- NPI 1972787273
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1422576000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1422576000000",
"number": "1366832230",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "44 S MAIN ST",
"address_2": "PO BOX 2000",
"city": "RANDOLPH",
"state": "VT",
"postal_code": "050601381",
"telephone_number": "802-728-7000",
"fax_number": "802-728-2143"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3556 RT 66",
"city": "RANDOLPH",
"state": "VT",
"postal_code": "050601318",
"telephone_number": "802-728-2125",
"fax_number": "802-728-2143"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "GIFFORD RETIREMENT COMMUNITY, INC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "GIFFORD RETIREMENT COMMUNITY, INC",
"enumeration_date": "2015-01-30",
"last_updated": "2015-01-30",
"status": "A",
"authorized_official_last_name": "HEBERT",
"authorized_official_first_name": "JEFFREY",
"authorized_official_middle_name": "C",
"authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
"authorized_official_telephone_number": "802-728-2356",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "313M00000X",
"taxonomy_group": "",
"desc": "Nursing Facility/Intermediate Care Facility",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Menig Nursing Home",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Randolph, VT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.