Active NPI
GL Virginia Poquoson, LLC
Doing business as Bayside of Poquoson Health and Rehab
- Skilled Nursing Facility
- Poquoson, VA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- Legal business name
- GL VIRGINIA POQUOSON, LLC
- Doing business as
- Bayside of Poquoson Health and Rehab
- Practice address
- 1 Vantage Dr
Poquoson, VA 23662-1400 - Phone
- (757) 868-9660
- Fax
- (757) 868-7319
- NPI assigned
- Dec 13, 2016
- Last updated
- Dec 13, 2016
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- David Rubenstein
- Title
- President and Ceo
- Phone
- (404) 786-8528
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | VA | Primary |
Addresses
Primary practice location
1 Vantage Dr
Poquoson, VA 23662-1400
Mailing address
1 Vantage Dr
Poquoson, VA 23662-1400
Phone (757) 868-9660
Other names 1
- Bayside of Poquoson Health and Rehab
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in VA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20170222000364 | VA | Part A Provider - Skilled Nursing Facility | 7012291982 | Practice locations: Poquoson, VA |
NPI to CCN mapping 1
The Medicare certification numbers (CCNs) connected to NPI 1396289187. Details of each certification follow.
Skilled nursing facility certification: CCN 495264
- Legal name
- GL VIRGINIA POQUOSON LLC
- Doing business as
- BAYSIDE OF POQUOSON HEALTH AND REHAB
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Jun 1, 1992
- Last certification
- Aug 29, 2024
- Beds
- 60
- Ownership / control type
- Corporation
- Most recent change of ownership
- Dec 16, 2016
- Organization structure
- LLC
- Incorporated
- Oct 11, 2016 in VA
- Enrollment address
- 1 Vantage Dr
Poquoson, VA 23662-1400 - Nursing home name
- BAYSIDE OF POQUOSON HEALTH AND REHAB
- Affiliated entity
- TRIO HEALTHCARE
Care Compare: Nursing home
Medicare Care Compare- Listed as
- Bayside of Poquoson Health and Rehab
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- For profit - Corporation
- Certified
- Jun 1, 1992
- Medicare certification status
- Active
- Certified beds
- 60
- Chain
- Trio Healthcare
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 |
|---|---|---|---|
| 49D0694287 | Bayside of Poquoson Health and Rehab | Certificate of waiver | Aug 31, 2026 |
National Provider Directory
National Provider DirectoryOwnership & related parties
All disclosed owners & managing parties 7
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 |
|---|---|---|---|
| Trio Healthcare Investors LLC | 5% Or Greater Indirect Ownership Interest | Dec 16, 2016 | 100% |
| Boyd P Gentry | 5% Or Greater Indirect Ownership Interest | Dec 16, 2016 | 42.9% |
| Corporate Officer | Dec 16, 2016 | ||
| Trio Health Care - East, LLC | 5% Or Greater Indirect Ownership Interest | May 24, 2019 | 100% |
| Trio Healthcare LLC | 5% Or Greater Indirect Ownership Interest | Dec 1, 2019 | 100% |
| GL Virginia Holdings LLC | 5% Or Greater Direct Ownership Interest | Dec 16, 2016 | 100% |
| David Rubenstein | 5% Or Greater Indirect Ownership Interest | Dec 16, 2016 | 57.1% |
| Corporate Officer | Dec 16, 2016 | ||
| Amanda Schlaikowski | W-2 Managing Employee | Sep 12, 2023 |
Facilities with the same owner 8
Facilities that share an organizational owner with 5% or greater ownership or operational control.
-
dba Alleghany Health and Rehab
- Skilled Nursing Facility
- Clifton Forge, VA
- NPI 1326582198
GL Virginia Holdings LLC, Trio Health Care - East, LLC, Trio Healthcare Investors LLC, Trio Healthcare LLC
-
dba Galax Health and Rehab
- Skilled Nursing Facility
- Galax, VA
- NPI 1336683101
GL Virginia Holdings LLC, Trio Health Care - East, LLC, Trio Healthcare Investors LLC, Trio Healthcare LLC
-
dba Elizabeth Adam Crump Health and Rehab
- Skilled Nursing Facility
- Glen Allen, VA
- NPI 1396289179
GL Virginia Holdings LLC, Trio Health Care - East, LLC, Trio Healthcare Investors LLC, Trio Healthcare LLC
-
dba Fredericksburg Health and Rehab
- Skilled Nursing Facility
- Fredericksburg, VA
- NPI 1255875027
GL Virginia Holdings LLC, Trio Health Care - East, LLC, Trio Healthcare Investors LLC, Trio Healthcare LLC
-
dba Martinsville Health and Rehab
- Skilled Nursing Facility
- Martinsville, VA
- NPI 1770027542
GL Virginia Holdings LLC, Trio Health Care - East, LLC, Trio Healthcare Investors LLC, Trio Healthcare LLC
-
dba Portsmouth Health and Rehab
- Skilled Nursing Facility
- Portsmouth, VA
- NPI 1497299275
GL Virginia Holdings LLC, Trio Health Care - East, LLC, Trio Healthcare Investors LLC, Trio Healthcare LLC
-
dba Rose Hill Health and Rehab
- Skilled Nursing Facility
- Berryville, VA
- NPI 1891239661
GL Virginia Holdings LLC, Trio Health Care - East, LLC, Trio Healthcare Investors LLC, Trio Healthcare LLC
-
dba Shenandoah Valley Health and Rehab
- Skilled Nursing Facility
- Buena Vista, VA
- NPI 1598201014
GL Virginia Holdings LLC, Trio Health Care - East, LLC, Trio Healthcare Investors LLC, Trio Healthcare LLC
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1481587200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1481587200000",
"number": "1396289187",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 VANTAGE DR",
"city": "POQUOSON",
"state": "VA",
"postal_code": "236621400",
"telephone_number": "757-868-9660",
"fax_number": "757-868-7319"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 VANTAGE DR",
"city": "POQUOSON",
"state": "VA",
"postal_code": "236621400",
"telephone_number": "757-868-9660",
"fax_number": "757-868-7319"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "GL VIRGINIA POQUOSON, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2016-12-13",
"last_updated": "2016-12-13",
"status": "A",
"authorized_official_last_name": "RUBENSTEIN",
"authorized_official_first_name": "DAVID",
"authorized_official_title_or_position": "PRESIDENT AND CEO",
"authorized_official_telephone_number": "404-786-8528"
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": "VA",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Bayside of Poquoson Health and Rehab",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Poquoson, VA
- Eckerd Corporation (Rite Aid Pharmacy 11287)
- Five Star Quality Care - VA, LLC (Dominion Village at Poquoson)
- Rebekah Forrest
- Kenyuatia Lynn Gash, LCSW, ACSW
- David Gilman, D.M.D.
- Good Steward ABA and Consulting LLC
- Hampton Roads Foot & Ankle Clinic
- David Shawn Hanberry
- Susan Hardouin
- William Harper, DDS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2016; 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.