Shor Co, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

SHOR CO, LLC

Practice address

1006 33Rd St
Vero Beach, FL 32960-6910

Phone

(772) 567-5248

NPI assigned

Feb 16, 2022

Last updated

Feb 16, 2022By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Kevin Rockefeller

Title

Manager

Phone

(904) 422-5231

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1407501661. Details of each certification follow.

• CCN 106097 Skilled nursing facility · Active · Details

Skilled nursing facility certification: CCN 106097

Legal name

SHOR CO LLC

Doing business as

HIDDEN LAKES SENIOR LIVING COMMUNITY

Certification status

Active

Provider type (POS)

Nursing home – SNF/NF dual certification

Participating since

Mar 19, 2013

Last certification

Aug 14, 2024

Beds

24

Ownership / control type

Limited Liability Corporation

Organization structure

LLCProprietary

Incorporated

Jan 3, 2022 in FL

Enrollment address

1006 33Rd St
Vero Beach, FL 32960-6910

Nursing home name

HIDDEN LAKES SENIOR LIVING COMMUNITY

Listed as

Hidden Lakes Senior Living CommunityCCN 106097 · All quality measures

Overall star rating

3 of 5

Health inspections

2 of 5

Staffing

4 of 5

Quality measures

5 of 5

Type

Medicare and Medicaid

Ownership

For profit - Limited Liability company

Certified

Mar 19, 2013

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

2420.2 residents per day on average

Processed by Care Compare on Aug 1, 2026.

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Networks

• Freedom Health HMO NetworkPlans: Freedom Platinum Rewards Plan Rx (HMO) (H5427-102-000, H5427); Freedom VIP Care (HMO C-SNP) (H5427-070-000, H5427); Freedom VIP Rewards (HMO C-SNP) (H5427-108-000, H5427); Freedom VIP Rewards (HMO C-SNP) (H5427-099-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-107-000, H5427); Freedom Máximo (HMO-POS) (H5427-113-000, H5427); Freedom Savings Plan (HMO) (H5427-052-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-096-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-105-000, H5427); Freedom Medi-Medi Full (HMO D-SNP) (H5427-087-000, H5427)…
• Optimum HealthCare HMO NetworkPlans: Optimum Diamond Rewards (HMO C-SNP) (H5594-028-000, H5594); Optimum Diamond (HMO C-SNP) (H5594-036-000, H5594); Optimum Diamond Rewards (HMO C-SNP) (H5594-034-000, H5594); Optimum Diamond Rewards COPD (HMO C-SNP) (H5594-029-000, H5594); Optimum Platinum Plan (HMO) (H5594-002-000, H5594); Optimum Gold Plus Plan (HMO) (H5594-032-000, H5594); Optimum Diamond Savings COPD (HMO C-SNP) (H5594-031-000, H5594); Optimum Diamond Savings (HMO C-SNP) (H5594-030-000, H5594); Optimum Diamond Rewards COPD (HMO C-SNP) (H5594-035-000, H5594)

All disclosed owners & managing parties 6

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

Facilities with the same owner 2

Facilities that share an organizational owner with 5% or greater ownership or operational control.

• BC SNF, LLC

  dba Buffalo Crossings Healthcare and Rehabilitation Center

  • Skilled Nursing Facility
  • The Villages, FL
  • NPI 1740949122

  KR Management, LLC

  CMS ownership
• Retirement Five, LLC

  dba Chatham Glen Healthcare and Rehabilitation Center

  • Skilled Nursing Facility
  • The Villages, FL
  • NPI 1639719081

  KR Management, LLC

  CMS ownership

Affiliated clinicians 1

Clinicians who list this facility as an affiliation in Medicare Care Compare.

• Hussien A Ballout, M.D.

  • Internal Medicine Physician
  • Vero Beach, FL
  • NPI 1376955682

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1644969600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1644969600000",
    "number": "1407501661",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 CLEARWATER LARGO RD S",
            "city": "LARGO",
            "state": "FL",
            "postal_code": "337703235",
            "telephone_number": "904-422-5231"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1006 33RD ST",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "329606910",
            "telephone_number": "772-567-5248"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHOR CO, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-02-16",
        "last_updated": "2022-02-16",
        "certification_date": "2022-02-16",
        "status": "A",
        "authorized_official_last_name": "ROCKEFELLER",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "904-422-5231"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laura M Sherman, APRN
• Donna Jean Sherrard
• Sherri D'Alessio, a.P. (A Place for Health, Inc.)
• Mark Sherrill
• Joshua B. Shipley, M.D.
• Laura Short, ARNP
• Stephen Jay Short Jr., D.C.
• Jenan Shraiteh, D.M.D.
• Kevin Shuker, PT
• Cheryl Ann Shulock, PTA

• Skilled Nursing Facility in Vero Beach, FL
• Providers in Vero Beach, FL by specialty
• Skilled Nursing Facility in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2022; 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.

Verify at the official NPI Registry.