Organization Active NPI

Gifford Retirement Community, Inc

Doing business as Menig Nursing Home

  • Nursing Facility/Intermediate Care Facility
  • Randolph, VT
National Provider Identifier
1366832230
Registry record updated Jan 30, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nursing Facility/Intermediate Care FacilityTaxonomy code 313M00000X
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, 2015By the provider in NPPES
Organization subpart
Yes
Parent organization
GIFFORD RETIREMENT COMMUNITY, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 30, 2015

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)CodeLicenseStatePrimary
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 Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
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
CorporationNon-profit
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 HomeCCN 475058 · All quality measures
Overall star rating
4 of 5
Health inspections
2 of 5
Staffing
5 of 5
Quality measures
5 of 5
Type
Medicare and Medicaid
Ownership
Non profit - Corporation
Certified
May 1, 2001
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
3029.9 residents per day on average
Penalties (3 years)
1Fines totaling $76,500

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
47D2145534Menig Nursing Home215 Tom Wicker Lane, Randolph Center, VT 05061Certificate of waiverMar 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.

NameRoleSinceShare
Heather E Impey Individual Operational/Managerial Control Jul 28, 2025
Adp of the SNF Mar 9, 2026
Kathleen Mason Individual Managing Control - Governing BodyBoard Member Jan 2, 2025
Trustee of the SNF Jan 2, 2025
Michael K Costa Individual Corporate DirectorChief Executive Officer Oct 3, 2024
Trustee of the SNF Oct 1, 2024
Victor Ribaudo Individual Managing Control - Governing BodyVice Chair Jan 2, 2025
Trustee of the SNF Jan 2, 2025
Cheyenne Holland Individual Corporate OfficerChief Financial Officer Aug 19, 2024
Operational/Managerial Control Aug 19, 2024
Trustee of the SNF Aug 19, 2024
Gifford Health Care Inc Organization, Randolph, VT Created for acquisition, Non-profit 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 Individual Managing Control - Governing BodyChair Jan 2, 2025
Trustee of the SNF Jan 2, 2025
Paul Putney Individual Managing Control - Governing BodyBoard Member Jan 2, 2025
Trustee of the SNF Jan 2, 2025
Kristin Chandler Individual Managing Control - Governing BodyBoard Member Jan 2, 2025
Cindy Rosalbo Individual Managing Control - Governing BodyBoard Member Jan 2, 2025
Trustee of the SNF Jan 2, 2025
Sarah Jackson Individual Managing Control - Governing Body Jan 2, 2025
Trustee of the SNF Jan 2, 2025
Cristine J Maloney Individual Operational/Managerial Control Jan 1, 2025
Adp of the SNF Mar 9, 2026
Morgan Rilling Individual Managing Control - Governing BodyBoard Member Jan 2, 2025
Trustee of the SNF Jan 2, 2025
Jamie Kinnarney Individual Managing Control - Governing BodyBoard Member Jan 2, 2025
Trustee of the SNF Jan 2, 2025
Peter Reed Individual Managing Control - Governing Body Jan 2, 2025
Trustee of the SNF Jan 2, 2025
Emilija O Florance Individual 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.

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.

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

Verify at the official NPI Registry.