Active NPI
Grayson Nursing & Rehabilitation Center LLC
- Skilled Nursing Facility
- Leitchfield, KY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- Legal business name
- GRAYSON NURSING & REHABILITATION CENTER LLC
- Practice address
- 505 William Thomason Byway
Leitchfield, KY 42754 - Phone
- (270) 259-3676
- NPI assigned
- Nov 2, 2022
- 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
- Mayer Fischi
- Title
- Owner/Managing Member
- Phone
- (718) 757-6399
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | Primary |
Addresses
Primary practice location
505 William Thomason Byway
Leitchfield, KY 42754
Mailing address
300 Provider Court
Richmond, KY 40475
Other names 1
- Grayson Nursing and Rehabilitation
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in KY
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20240318002538 | KY | Part A Provider - Skilled Nursing Facility | 5698112340 | Practice locations: Leitchfield, KY |
Skilled nursing facility certification: CCN 185177
- Legal name
- GRAYSON NURSING & REHABILITATION CENTER LLC
- Doing business as
- GRAYSON NURSING AN DREHAB CENTER
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Apr 19, 1985
- Last certification
- Nov 21, 2024
- Beds
- 72
- Ownership / control type
- Limited Liability Corporation
- Multi-facility organization
- Encore Health Partners
- Organization structure
- LLC
- Enrollment address
- 505 William Thomason Byu
Leitchfield, KY 42754-1419 - Nursing home name
- GRAYSON NURSING AND REHAB CENTER
- Affiliated entity
- ENCORE HEALTH PARTNERS
Care Compare: Nursing home
Medicare Care Compare- Listed as
- Grayson Nursing and Rehab Center
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- For profit - Limited Liability company
- Certified
- Apr 19, 1985
- Medicare certification status
- Active
- Certified beds
- 72
- Chain
- Encore Health Partners
- Penalties (3 years)
- 5
National Provider Directory
National Provider DirectoryOwnership & related parties
All disclosed owners & managing parties 34
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 |
|---|---|---|---|
| Baldwin Cpas PLLC | Adp of the SNF | Oct 20, 2023 | |
| Mayer Fischel | Corporate Officer | Oct 20, 2023 | 100% |
| Operational/Managerial Control | Oct 20, 2023 | ||
| Adp of the SNF | Oct 20, 2023 | ||
| Timothy Eldridge | Adp of the SNF | Oct 20, 2023 | |
| Kelly Stone | Adp of the SNF | Oct 20, 2023 | |
| Encore Health Partners 2 LLC | Operational/Managerial Control | Oct 20, 2023 | |
| Adp of the SNF | Apr 16, 2025 | ||
| Hargis & Associates, LLC | Adp of the SNF | Jan 1, 2022 | |
| Cbre Capital Markets Inc | 5% Or Greater Mortgage Interest | Oct 20, 2023 | 50% |
| Sarah Zoberman | Adp of the SNF | Oct 20, 2023 | |
| Indirect Ownership Interest | Oct 20, 2023 | 2.5% | |
| Myron Fisher | Adp of the SNF | Oct 20, 2023 | |
| Sarah McIntosh | Adp of the SNF | Jan 1, 2022 | |
| Forwood E Hargis | Adp of the SNF | Jan 1, 2024 | |
| Leon Everett Butler | Adp of the SNF | Oct 20, 2023 | |
| David Bloom | Adp of the SNF | Oct 20, 2023 | |
| Indirect Ownership Interest | Oct 20, 2023 | 5% | |
| Christopher Hatcher | Adp of the SNF | Oct 20, 2023 | |
| Balt M4 LLC | Adp of the SNF | Oct 20, 2023 | |
| Perigrove 1034 LLC | Adp of the SNF | Oct 20, 2023 | |
| J&R KC Derby Ky Family Investments LLC | Adp of the SNF | Oct 20, 2023 | |
| J & R Family Investments, LLC | Adp of the SNF | Oct 20, 2023 | |
| Melinda Fulkerson | Operational/Managerial Control | Oct 20, 2023 | |
| Adp of the SNF | Oct 20, 2023 | ||
| Beth Overbey | Adp of the SNF | Oct 20, 2023 | |
| 505 William Thomason Byway Realty LLC | 5% Or Greater Mortgage Interest | Oct 20, 2023 | 100% |
| Adp of the SNF | Oct 20, 2023 | ||
| Eli Grinspan | 5% Or Greater Indirect Ownership Interest | Oct 20, 2023 | 72.5% |
| Corporate Officer | Oct 20, 2023 | 100% | |
| Operational/Managerial Control | Oct 20, 2023 | ||
| Managing Control - Governing Body | Oct 20, 2023 | ||
| Adp of the SNF | Oct 20, 2023 | ||
| KC Derby Ky Partners LLC | Adp of the SNF | Oct 20, 2023 | |
| David Rubenstein | Adp of the SNF | Oct 20, 2023 | |
| David Gefner | Adp of the SNF | Oct 20, 2023 | |
| Lisa Foley | Adp of the SNF | Oct 20, 2023 | |
| Encore Realty 2 LLC | Adp of the SNF | Oct 20, 2023 | |
| KC Derby Ky Parent LLC | Adp of the SNF | Oct 20, 2023 | |
| Landau Family Investment Trust | Adp of the SNF | Oct 20, 2023 | |
| Isaac Grinspan | Adp of the SNF | Oct 20, 2023 | |
| Encore Parent Holdings LLC | 5% Or Greater Direct Ownership Interest | Oct 20, 2023 | 100% |
| Gefner Family Holding LLC | Adp of the SNF | Oct 20, 2023 | |
| Encore Investors 2 LLC | 5% Or Greater Indirect Ownership Interest | Oct 20, 2023 | 100% |
| KC Derby Ky JV LLC | Adp of the SNF | Oct 20, 2023 |
Owners & managing parties with NPI records 1
Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.
-
- Internal Medicine Physician
- Louisville, KY
- NPI 1689754822
Adp of the SNF
Facilities with the same owner 6
Facilities that share an organizational owner with 5% or greater ownership or operational control.
-
- Skilled Nursing Facility
- Florence, KY
- NPI 1295442937
Encore Health Partners 2 LLC, Encore Investors 2 LLC, Encore Parent Holdings LLC
-
- Skilled Nursing Facility
- Madisonville, KY
- NPI 1376250019
Encore Health Partners 2 LLC, Encore Investors 2 LLC, Encore Parent Holdings LLC
-
- Skilled Nursing Facility
- Woodburn, KY
- NPI 1265149900
Encore Health Partners 2 LLC, Encore Investors 2 LLC, Encore Parent Holdings LLC
-
- Skilled Nursing Facility
- Elizabethtown, KY
- NPI 1790492437
Encore Health Partners 2 LLC, Encore Investors 2 LLC, Encore Parent Holdings LLC
-
- Skilled Nursing Facility
- Louisville, KY
- NPI 1730896473
Encore Health Partners 2 LLC, Encore Investors 2 LLC, Encore Parent Holdings LLC
-
- Skilled Nursing Facility
- Louisville, KY
- NPI 1851008585
Encore Health Partners 2 LLC, Encore Investors 2 LLC, Encore Parent Holdings LLC
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Internal Medicine Physician
- Louisville, KY
- NPI 1689754822
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1667347200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1667433600000",
"number": "1457068199",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "300 PROVIDER COURT",
"city": "RICHMOND",
"state": "KY",
"postal_code": "40475"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "505 WILLIAM THOMASON BYWAY",
"city": "LEITCHFIELD",
"state": "KY",
"postal_code": "42754",
"telephone_number": "270-259-3676"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "GRAYSON NURSING & REHABILITATION CENTER LLC",
"organizational_subpart": "NO",
"enumeration_date": "2022-11-02",
"last_updated": "2022-11-03",
"certification_date": "2022-11-03",
"status": "A",
"authorized_official_last_name": "FISCHI",
"authorized_official_first_name": "MAYER",
"authorized_official_title_or_position": "OWNER/MANAGING MEMBER",
"authorized_official_telephone_number": "718-757-6399"
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Grayson Nursing and Rehabilitation",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Leitchfield, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 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.