Big Stone Gap Life Care, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

NH2568 Issued in VA

Legal business name

BIG STONE GAP LIFE CARE, LLC

Doing business as

Heritage Hall - Big Stone Gap

Practice address

2045 Valley View Dr
Big Stone Gap, VA 24219-3319

Phone

(276) 523-3000

Fax

(276) 523-0531

NPI assigned

Jun 5, 2018

Last updated

Nov 25, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Cassandra Gallant

Title

Compliance & Privacy Officer

Phone

(540) 774-4263

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• Heritage Hall - Big Stone Gap Doing business as

Tax ID family

American Healthcare LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Big Stone Gap Life Care, LLC

  dba Heritage Hall - Big Stone Gap

  • Skilled Nursing Facility
  • Big Stone Gap, VA
  • NPI 1679563068
  NPD tax ID

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

{
    "created_epoch": "1528156800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1732492800000",
    "number": "1518459593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2045 VALLEY VIEW DR",
            "city": "BIG STONE GAP",
            "state": "VA",
            "postal_code": "242193319",
            "telephone_number": "276-523-3000",
            "fax_number": "276-523-0531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2045 VALLEY VIEW DR",
            "city": "BIG STONE GAP",
            "state": "VA",
            "postal_code": "242193319",
            "telephone_number": "276-523-3000",
            "fax_number": "276-523-0531"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BIG STONE GAP LIFE CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-06-05",
        "last_updated": "2024-11-25",
        "certification_date": "2024-11-25",
        "status": "A",
        "authorized_official_last_name": "GALLANT",
        "authorized_official_first_name": "CASSANDRA",
        "authorized_official_title_or_position": "COMPLIANCE & PRIVACY OFFICER",
        "authorized_official_telephone_number": "540-774-4263"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "VA",
            "license": "NH2568",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "180506",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FEDERAL BLACK LUNG",
            "identifier": "200515602",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4951352",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Heritage Hall - Big Stone Gap",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Heritage Hall - Big Stone Gap",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Rhonda Alane Bennett, BS
• Jennifer A Beverly, RN C
• Teresa Beverly, LPN
• Rebecca Bevins, PT, DPT
• Big Stone Economy Drug Inc
• Big Stone Gap Life Care, LLC (Heritage Hall - Big Stone Gap)
• Big Stone Gap Rescue Squad, Inc.
• Patty Biles, CRNA
• Christopher Eugene Bishop, DO
• Doris Jean Bishop

• Skilled Nursing Facility in Big Stone Gap, VA
• Providers in Big Stone Gap, VA by specialty
• Skilled Nursing Facility in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.