4294 3Rd Avenue Operations, LLC
Organization Active NPI Skilled Nursing Facility · Marianna, FL
NPI 1487301982 · NPPES record last updated Sep 13, 2024
Key facts
- NPI
- 1487301982
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Skilled Nursing Facility 314000000X
- Legal business name
- 4294 3RD AVENUE OPERATIONS, LLC
- Practice address
- 4294 3Rd Ave
Marianna, FL 32446-2137 - Phone
- (850) 526-3191
- Fax
- (850) 526-4481
- NPI assigned
- Mar 4, 2022
- Organization subpart
- No
Authorized official
- Name
- Tim Lehner
- Title
- Manager
- Phone
- (770) 698-9040
Owners & managing parties with NPI records 1
-
Mark R Akerson, MD
Facilities with the same owner 5
Affiliated clinicians 7
-
Mark R Akerson, MD
-
Robin Edward Albritton, M.D.
-
John Garmany Brunner, D.O.
-
Murali Krishna Maddipati, M.D.,
-
John A. Spence, M. D.
Medicare Care Compare: Nursing home
- Listed as
- Chipola Health and Rehabilitation Center
- Overall star rating
- ★★★★☆ 4 of 5
- Health inspections
- ★★★★☆ 4 of 5
- Staffing
- ★★★★☆ 4 of 5
- Quality measures
- ★★★★☆ 4 of 5
- Type
- Medicare and Medicaid
- Ownership
- For profit - Limited Liability company
- Certified
- May 7, 1991
- Medicare certification status
- Active
- Certified beds
- 60 · 53.0 residents per day on average
- Chain
- Consulate Health Care/Independence Living Centers/Nspire Healthcare/Raydiant Health Care
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in FL
Skilled nursing facility certification: CCN 105729
- Legal name
- 4294 3RD AVENUE OPERATIONS, LLC
- Doing business as
- CHIPOLA HEALTH AND REHABILITATION CENTER
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- May 7, 1991
- Last certification
- Apr 17, 2024
- Beds
- 60
- Ownership / control type
- Limited Liability Corporation
- Organization structure
- LLC
- Incorporated
- Feb 15, 2022 in FL
- Enrollment address
- 4294 3Rd Ave
Marianna, FL 32446-2137 - Nursing home name
- CHIPOLA HEALTH AND REHABILITATION CENTER
- Affiliated entity
- CONSULATE HEALTH CARE/INDEPENDENCE LIVING CENTERS/NSPIRE HEALTHCARE/RAYDIANT HEALTH CARE
All disclosed owners & managing parties 20
| Name | Role | Since | Share |
|---|---|---|---|
| LV Investment LLC |
5% Or Greater Indirect Ownership Interest | Apr 1, 2022 | 100% |
| NSPR Operations II, LLC |
5% Or Greater Indirect Ownership Interest | Apr 1, 2022 | 100% |
| Ashley Winkle |
Operational/Managerial Control | Dec 10, 2024 | |
| Mark R Akerson |
Operational/Managerial Control | Apr 1, 2022 | |
| Adp of the SNF | Apr 1, 2022 | ||
| Nsprmc, LLC |
Operational/Managerial Control | Jun 1, 2025 | |
| Adp of the SNF | Jul 10, 2025 | ||
| Bradley Lee |
Operational/Managerial Control | Jun 1, 2025 | |
| Managing Control - Governing Body | Dec 10, 2024 | ||
| Adp of the SNF | Jun 1, 2025 | ||
| |
Trustee of the SNF | Apr 1, 2022 | |
| Adp of the SNF | Jul 10, 2025 | ||
| |
Trustee of the SNF | Apr 1, 2022 | |
| Adp of the SNF | May 14, 2025 | ||
| |
Adp of the SNF | May 14, 2025 | |
| FC Investors Xxi LLC |
5% Or Greater Indirect Ownership Interest | Apr 1, 2022 | 100% |
| |
Adp of the SNF | May 14, 2025 | |
| Fmrgc Holdco, LLC |
5% Or Greater Direct Ownership Interest | Apr 1, 2022 | 100% |
| Cse Marianna Holdings, LLC |
5% Or Greater Security Interest | Apr 1, 2022 | |
| Adp of the SNF | Apr 1, 2022 | ||
| NSPR Care Centers, LLC |
5% Or Greater Indirect Ownership Interest | Apr 1, 2022 | 100% |
| Tiffany Hoback |
Managing Control - Governing Body | Jun 1, 2025 | |
| NSPR Operations I, LLC |
5% Or Greater Indirect Ownership Interest | Apr 1, 2022 | 100% |
| Tequilla Jones |
Operational/Managerial Control | Mar 20, 2025 | |
| Adp of the SNF | Mar 20, 2025 | ||
| Treva Pomes |
Operational/Managerial Control | Aug 22, 2023 | |
| Adp of the SNF | Aug 22, 2023 | ||
| Lavie Holdco LLC |
5% Or Greater Indirect Ownership Interest | Apr 1, 2022 | 100% |
| Andrea Hingson |
Operational/Managerial Control | Sep 2, 2025 | |
| Adp of the SNF | Sep 2, 2025 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20220415000042 | FL | Part a Provider - Skilled Nursing Facility | 2668868894 | Practice locations: Marianna, FL |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | Yes |
Addresses
Primary practice location
4294 3Rd Ave
Marianna, FL 32446-2137
Mailing address
4294 3Rd Ave
Marianna, FL 32446-2137
Phone (850) 526-3191
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000538300 | Medicaid | FL |
Other names
- Chipola Health and Rehabilitation Center
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | https://65.196.137.118:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRResponse_Service | Other | Consulate Healthcare |
Other providers in Marianna, FL
All providers in Marianna, FL · Skilled Nursing Facility in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 13, 2024. 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.