NPIMap

Organization Active NPI

4294 3Rd Avenue Operations, LLC

Doing business as Chipola Health and Rehabilitation Center

  • Skilled Nursing Facility
  • Marianna, FL
National Provider Identifier
1487301982
Registry record updated Sep 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
4294 3RD AVENUE OPERATIONS, LLC
Doing business as
Chipola Health and Rehabilitation Center
Practice address
4294 3Rd Ave
Marianna, FL 32446-2137
Phone
(850) 526-3191
Fax
(850) 526-4481
NPI assigned
Mar 4, 2022
Last updated
Sep 13, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2024

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

Authorized official

Name
Tim Lehner
Title
Manager
Phone
(770) 698-9040

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

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 1

IdentifierTypeStateIssuer
000538300MedicaidFL

Other names 1

  • Chipola Health and Rehabilitation Center Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://65.196.137.118:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRResponse_Service Other Consulate Healthcare

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220415000042 FL Part A Provider - Skilled Nursing Facility 2668868894 Practice locations: Marianna, FL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1487301982. Details of each certification follow.

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

Care Compare: Nursing home

Medicare Care Compare
Listed as
Chipola Health and Rehabilitation CenterCCN 105729 · 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 and Medicaid
Ownership
For profit - Limited Liability company
Certified
May 7, 1991
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
6053.0 residents per day on average
Chain
Consulate Health Care/Independence Living Centers/Nspire Healthcare/Raydiant Health Care11 facilities in the chain

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 20

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

NameRoleSinceShare
LV Investment LLC Organization, Maitland, FL LLC, Holding company, For-profit, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Apr 1, 2022 100%
NSPR Operations II, LLC Organization, Tamarac, FL LLC, Holding company, For-profit 5% Or Greater Indirect Ownership Interest Apr 1, 2022 100%
Ashley Winkle Individual Operational/Managerial Control Dec 10, 2024
Mark R Akerson Individual Operational/Managerial Control Apr 1, 2022
Adp of the SNF Apr 1, 2022
Nsprmc, LLC Organization, Tamarac, FL LLC, Management services company, For-profit, Chain home office Operational/Managerial Control Jun 1, 2025
Adp of the SNF Jul 10, 2025
Bradley Lee Individual Operational/Managerial Control Jun 1, 2025
Managing Control - Governing Body Dec 10, 2024
Adp of the SNF Jun 1, 2025
Organization, Atlanta, GA LLC, For-profit Trustee of the SNF Apr 1, 2022
Adp of the SNF Jul 10, 2025
Organization, Kennett Square, PA LLC, For-profit Trustee of the SNF Apr 1, 2022
Adp of the SNF May 14, 2025
Organization, Orlando, FL Corporation, For-profit Adp of the SNF May 14, 2025
FC Investors Xxi LLC Organization, Maitland, FL LLC, Holding company, For-profit, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Apr 1, 2022 100%
Organization, Woonsocket, RI LLC, For-profit Adp of the SNF May 14, 2025
Fmrgc Holdco, LLC Organization, Tamarac, FL LLC, Holding company, For-profit, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Apr 1, 2022 100%
Cse Marianna Holdings, LLC Organization, Hunt Valley, MD LLC, For-profit, Real estate investment trust (REIT), Owned by another organization or individual 5% Or Greater Security Interest Apr 1, 2022
Adp of the SNF Apr 1, 2022
NSPR Care Centers, LLC Organization, Tamarac, FL LLC, Holding company, For-profit, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Apr 1, 2022 100%
Tiffany Hoback Individual Managing Control - Governing Body Jun 1, 2025
NSPR Operations I, LLC Organization, Tamarac, FL LLC, Holding company, For-profit, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Apr 1, 2022 100%
Tequilla Jones Individual Operational/Managerial Control Mar 20, 2025
Adp of the SNF Mar 20, 2025
Treva Pomes Individual Operational/Managerial Control Aug 22, 2023
Adp of the SNF Aug 22, 2023
Lavie Holdco LLC Organization, Atlanta, GA LLC, Holding company, For-profit, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Apr 1, 2022 100%
Andrea Hingson Individual Operational/Managerial Control Sep 2, 2025
Adp of the SNF Sep 2, 2025

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 5

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

Practitioners & affiliated clinicians

Affiliated clinicians 7

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": "1646352000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1726185600000",
    "number": "1487301982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4294 3RD AVE",
            "city": "MARIANNA",
            "state": "FL",
            "postal_code": "324462137",
            "telephone_number": "850-526-3191",
            "fax_number": "850-526-4481"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4294 3RD AVE",
            "city": "MARIANNA",
            "state": "FL",
            "postal_code": "324462137",
            "telephone_number": "850-526-3191",
            "fax_number": "850-526-4481"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "4294 3RD AVENUE OPERATIONS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-04",
        "last_updated": "2024-09-13",
        "certification_date": "2024-09-13",
        "status": "A",
        "authorized_official_last_name": "LEHNER",
        "authorized_official_first_name": "TIM",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "770-698-9040"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000538300",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://65.196.137.118:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRResponse_Service",
            "affiliation": "Y",
            "endpointDescription": "urn:oid:2.16.840.1.113883.3.5042",
            "affiliationName": "Consulate Healthcare",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "800 Concourse Pkwy S Ste 200",
            "city": "Maitland",
            "state": "FL",
            "country_code": "US",
            "postal_code": "327516148",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Chipola Health and Rehabilitation Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Chipola Health and Rehabilitation Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Marianna, FL

Sources for this page

Verify at the official NPI Registry.