NPIMap

Organization Active NPI

Berea Healthcare, LLC

Doing business as Berea Acquisition, LLC

  • Skilled Nursing Facility
  • Berea, KY
National Provider Identifier
1619487741
Registry record updated Oct 3, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
BEREA HEALTHCARE, LLC
Doing business as
Berea Acquisition, LLC
Practice address
601 Richmond Rd N
Berea, KY 40403-8788
Phone
(859) 623-0898
NPI assigned
Oct 3, 2017
Last updated
Oct 3, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2017

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

Authorized official

Name
Mr. Bent Philipson
Title
Managing Member
Phone
(859) 623-0898

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

601 Richmond Rd N
Berea, KY 40403-8788

Mailing address

300 Provider CT
Richmond, KY 40475-8488
Phone (859) 623-0898

Other names 1

  • Berea Acquisition, LLC Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20171212002748 KY Part A Provider - Skilled Nursing Facility 2860750270 Practice locations: Berea, KY

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1619487741. Details of each certification follow.

Skilled nursing facility certification: CCN 185384

Legal name
BEREA HEALTHCARE LLC
Doing business as
BEREA HEALTH AND REHABILITATION
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Sep 28, 1993
Last certification
Apr 10, 2025
Beds
84
Ownership / control type
Partnership
Most recent change of ownership
Sep 29, 2017
Organization structure
LLCProprietary
Enrollment address
601 Richmond Rd N
Berea, KY 40403-8788
Nursing home name
BEREA HEALTH AND REHABILITATION
Affiliated entity
BLUEGRASS HEALTH KY

Care Compare: Nursing home

Medicare Care Compare
Listed as
Berea Health and RehabilitationCCN 185384 · All quality measures
Overall star rating
3 of 5
Health inspections
4 of 5
Staffing
1 of 5
Quality measures
4 of 5
Type
Medicare and Medicaid
Ownership
For profit - Partnership
Certified
Sep 28, 1993
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
8478.3 residents per day on average
Chain
Bluegrass Health Ky15 facilities in the chain
Penalties (3 years)
2Fines totaling $16,801

Processed by Care Compare on Aug 1, 2026.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
18D0892103Berea Healthcare Center601 Richmond Rd PO Box 4068, Berea, KY 40403Certificate of waiverSep 22, 2026

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 18

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

NameRoleSinceShare
Individual Adp of the SNF Nov 1, 2016
Mayer Fischel Individual 5% Or Greater Direct Ownership Interest Jan 31, 2023 33.33%
Corporate OfficerCfo Nov 1, 2016 100%
Operational/Managerial ControlCfo of Valley Stream Operator I Nov 1, 2016
Adp of the SNF Nov 1, 2016
Individual Adp of the SNF Nov 1, 2016
Huntington Bank Organization, Columbus, OH Corporation, Financial institution, Owned by another organization or individual 5% Or Greater Mortgage Interest Jan 31, 2023 79%
Individual Adp of the SNF Nov 1, 2016
Cynthia Hollins Individual Adp of the SNF Jun 12, 2023
Valley Stream Operator I LLC Organization, Richmond, KY LLC, Management services company, Chain home office Operational/Managerial Control Nov 1, 2016
Adp of the SNF Apr 14, 2025
Individual Adp of the SNF Nov 1, 2016
Individual Adp of the SNF Jan 1, 2022
Eli Grinspan Individual 5% Or Greater Direct Ownership Interest Jan 31, 2023 33.33%
Corporate OfficerCoo Nov 1, 2016 100%
Operational/Managerial ControlManaging Member Nov 1, 2016
Adp of the SNF Nov 1, 2016
Organization, Richmond, KY LLC Adp of the SNF May 9, 2025
Individual Adp of the SNF Nov 1, 2016
Dustin K Devers Individual Adp of the SNF Oct 1, 2017
Organization, Russellville, KY LLC Adp of the SNF Apr 14, 2025
Benjamin Landa Individual 5% Or Greater Direct Ownership Interest Jan 31, 2023 33.34%
Adp of the SNF Jan 1, 2023
Berea Realty Holdings LLC Organization, Berea, KY Created for acquisition, LLC, Owned by another organization or individual 5% Or Greater Mortgage Interest Jan 31, 2023 79%
Adp of the SNF Nov 1, 2016
Christal Mullins Individual Operational/Managerial Control Oct 2, 2024
Adp of the SNF Oct 2, 2024
Individual Adp of the SNF Jan 1, 2022

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 13

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

View all 13

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

Affiliated clinicians 2

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": "1506988800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1506988800000",
    "number": "1619487741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 PROVIDER CT",
            "city": "RICHMOND",
            "state": "KY",
            "postal_code": "404758488",
            "telephone_number": "859-623-0898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 RICHMOND RD N",
            "city": "BEREA",
            "state": "KY",
            "postal_code": "404038788",
            "telephone_number": "859-623-0898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEREA HEALTHCARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-10-03",
        "last_updated": "2017-10-03",
        "status": "A",
        "authorized_official_last_name": "PHILIPSON",
        "authorized_official_first_name": "BENT",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "859-623-0898",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Berea Acquisition, LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Berea, KY

Sources for this page

Verify at the official NPI Registry.