NPIMap

Organization Active NPI

Seaside the Health Center at Atlantic Shores, LLC

  • Skilled Nursing Facility
  • Virginia Beach, VA
National Provider Identifier
1417956673
Registry record updated Oct 24, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
NH2678 Issued in VA
Legal business name
SEASIDE THE HEALTH CENTER AT ATLANTIC SHORES, LLC
Practice address
1200 Atlantic Shores Dr
Virginia Beach, VA 23454-7311
Phone
(757) 716-2060
Fax
(757) 716-2019
NPI assigned
Jul 20, 2005
Last updated
Oct 24, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2017

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

Authorized official

Name
Brenda L Rosenbaugh
Title
Medical Billing Supervisor
Phone
(757) 716-2065

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X ERO 03-176 VA
Skilled Nursing Facility 314000000X NH2678 VA Primary

Addresses

Primary practice location

1200 Atlantic Shores Dr
Virginia Beach, VA 23454-7311

Mailing address

1200 Atlantic Shores Dr
Virginia Beach, VA 23454-7311
Phone (757) 716-2060

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20111209000069 VA Part A Provider - Skilled Nursing Facility 1658303805 Practice locations: Virginia Beach, VA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1417956673. Details of each certification follow.

Skilled nursing facility certification: CCN 495324

Legal name
SEASIDE THE HEALTH CENTER AT ATLANTIC SHORES LLC
Doing business as
SEASIDE THE HEALTH CENTER AT ATLANTIC SHORES
Certification status
Active
Provider type (POS)
Nursing home – SNF (Medicare) only
Participating since
Sep 12, 1997
Last certification
Jan 6, 2022
Beds
50
Ownership / control type
Limited Liability Corporation
Organization structure
LLCProprietary
Incorporated
Nov 9, 2011 in VA
Enrollment address
1200 Atlantic Shores Dr
Virginia Beach, VA 23454-7311
Nursing home name
SEASIDE HHC @ ATLANTIC SHORE

Care Compare: Nursing home

Medicare Care Compare
Listed as
Seaside HHC @ Atlantic ShoreCCN 495324 · All quality measures
Overall star rating
4 of 5
Health inspections
4 of 5
Staffing
4 of 5
Quality measures
4 of 5
Type
Medicare
Ownership
For profit - Limited Liability company
Certified
Sep 12, 1997
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
5038.5 residents per day on average

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 11

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

NameRoleSinceShare
Mike Loy McGraw Individual Corporate DirectorBoard Member Nov 18, 2021
Jennifer Maugeri Individual Contracted Managing EmployeeExecutive Director Jun 15, 2020
Corporate OfficerExecutive Director Jun 15, 2020
Michael Cicchese Individual Corporate DirectorBoard Member Nov 20, 2019
Life Care Services LLC Organization, Des Moines, IA Management services company Operational/Managerial Control Jan 1, 2020
Melissa Sullivan Individual Corporate DirectorBoard Member Nov 20, 2019
Donna Kelsey Individual Corporate DirectorBoard Member Nov 20, 2019
Keith R Knapp Individual Corporate DirectorBoard Member Nov 20, 2019
Atlantic Shores Cooperative Association Inc Organization, Virginia Beach, VA Corporation Operational/Managerial Control Aug 29, 2022 100%
Elizabeth a. Dammeyer Individual W-2 Managing EmployeeAdministrator Jan 5, 2021
Operational/Managerial ControlAdminstrator Jan 5, 2022
Richard Quarles Individual Corporate DirectorBoard Member Nov 20, 2019
Roger George Rawden Individual Corporate DirectorBoard Member Nov 18, 2021

Facilities with the same owner 57

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

View all 57

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Affiliated clinicians 8

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

NPI Registry JSON

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

{
    "created_epoch": "1121817600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1508803200000",
    "number": "1417956673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 ATLANTIC SHORES DR",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234547311",
            "telephone_number": "757-716-2060",
            "fax_number": "757-716-2019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 ATLANTIC SHORES DR",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234547311",
            "telephone_number": "757-716-2060",
            "fax_number": "757-716-2019"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SEASIDE THE HEALTH CENTER AT ATLANTIC SHORES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-20",
        "last_updated": "2017-10-24",
        "status": "A",
        "authorized_official_last_name": "ROSENBAUGH",
        "authorized_official_first_name": "BRENDA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "MEDICAL BILLING SUPERVISOR",
        "authorized_official_telephone_number": "757-716-2065"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "VA",
            "license": "ERO 03-176",
            "primary": false
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "VA",
            "license": "NH2678",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Virginia Beach, VA

Sources for this page

Verify at the official NPI Registry.