Roanoke Healthcare Center LLC
Organization Active NPI Skilled Nursing Facility · Roanoke, AL
NPI 1477597227 · NPPES record last updated Nov 14, 2016
Key facts
- NPI
- 1477597227
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Skilled Nursing Facility 314000000X
- License
- 12666 (AL)
- Legal business name
- ROANOKE HEALTHCARE CENTER LLC
- Practice address
- 680 Seymour Dr
Roanoke, AL 36274-1547 - Phone
- (334) 863-6151
- Fax
- (334) 863-4816
- NPI assigned
- Jun 15, 2006
- Organization subpart
- No
Authorized official
- Name
- Ms. Emilee R Fenaes
- Title
- Administrator
- Phone
- (334) 863-6151
Owners & managing parties with NPI records 1
-
Carla N Thomas, M.D.
Practitioners 3
-
Russell D Peterson, D.O.
-
Mitchell Carey Shirah, M.D.
-
Carla N Thomas, M.D.
Affiliated clinicians 3
-
Russell D Peterson, D.O.
-
Mitchell Carey Shirah, M.D.
-
Carla N Thomas, M.D.
Medicare Care Compare: Nursing home
- Listed as
- Roanoke Rehabilitation & Healthcare Center
- Overall star rating
- ★★☆☆☆ 2 of 5
- Health inspections
- ★★☆☆☆ 2 of 5
- Staffing
- ★★★☆☆ 3 of 5
- Quality measures
- ★★★★☆ 4 of 5
- Type
- Medicare and Medicaid
- Ownership
- For profit - Corporation
- Certified
- Jul 12, 1993
- Medicare certification status
- Active
- Certified beds
- 65 · 56.5 residents per day on average
- Chain
- Ball Healthcare Services
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AL
Skilled nursing facility certification: CCN 015424
- Legal name
- ROANOKE HEALTHCARE CENTER LLC
- Doing business as
- ROANOKE REHABILITATION & HEALTHCARE CENTER
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Jul 12, 1993
- Last certification
- Sep 20, 2023
- Beds
- 65
- Ownership / control type
- Corporation
- Multi-facility organization
- BALL HEALTH CARE SERVICES
- Most recent change of ownership
- Jul 1, 2003
- Organization structure
- LLC · Proprietary
- Incorporated
- May 14, 2003 in AL
- Enrollment address
- 680 Seymour Dr
Roanoke, AL 36274-1547 - Nursing home name
- ROANOKE REHABILITATION & HEALTHCARE CENTER
- Affiliated entity
- BALL HEALTHCARE SERVICES
All disclosed owners & managing parties 10
| Name | Role | Since | Share |
|---|---|---|---|
| Clarence Melvin Ball |
5% Or Greater Direct Ownership Interest |
Jul 1, 2003 | 100% |
| Corporate Director |
Jul 21, 2003 | 100% | |
| Wendy L. Oubre |
Operational/Managerial Control | Jul 14, 2025 | |
| Adp of the SNF | Oct 8, 2025 | ||
| |
Adp of the SNF | Apr 15, 2025 | |
| Ball Healthcare Service, Inc |
Adp of the SNF | Apr 15, 2025 | |
| Matthew Hall |
Corporate Officer |
Sep 16, 2014 | 100% |
| Adp of the SNF | Oct 1, 2014 | ||
| |
Adp of the SNF | Apr 15, 2025 | |
| Ball Healthcare - Roanoke, Inc |
Adp of the SNF | Jul 1, 2003 | |
| Hollie Caldwell |
Operational/Managerial Control | Jan 13, 2011 | |
| Adp of the SNF | Jan 13, 2011 | ||
| |
Adp of the SNF | Apr 15, 2025 | |
| Carla N Thomas |
Operational/Managerial Control | Jan 12, 2021 | |
| Adp of the SNF | Jan 13, 2011 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20030711000032 | AL | Part a Provider - Skilled Nursing Facility | 4183534076 | Practice locations: Roanoke, AL |
National Provider Directory
Locations
680 Seymour Dr
Roanoke, AL 36274
Phone (334) 863-6151
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | 12666 | AL | Yes |
Addresses
Primary practice location
680 Seymour Dr
Roanoke, AL 36274-1547
Mailing address
1 Southern Way
Mobile, AL 36619-1210
Phone (251) 433-9801
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 475795OS | Medicaid | AL |
Other providers in Roanoke, AL
- Roanoke Healthcare Authority
- Roanoke Healthcare Authority
- Roanoke Healthcare Authority
- Roanoke Healthcare Authority
- Roanoke Healthcare Authority
- Michael Robinson
- Helen Scharko
- Dalton Screws
- Mitchell Carey Shirah
- Jagroop Singh
All providers in Roanoke, AL · Skilled Nursing Facility in Alabama
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 14, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.