NPIMap

Organization Active NPI

Berry Hill Nursing Home, Inc.

Doing business as Berry Hill Nursing Home

  • Skilled Nursing Facility
  • South Boston, VA
National Provider Identifier
1649215252
Registry record updated Jul 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
NH2502 Issued in VA
Legal business name
BERRY HILL NURSING HOME, INC.
Doing business as
Berry Hill Nursing Home
Practice address
621 Berry Hill Rd
South Boston, VA 24592-2207
Phone
(434) 572-8901
Fax
(434) 572-8904
NPI assigned
Jun 18, 2006
Last updated
Jul 14, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2021

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

Authorized official

Name
Mrs. Gale Boice
Title
Cfo
Phone
(252) 523-9094

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X NH2502 VA Primary

Addresses

Primary practice location

621 Berry Hill Rd
South Boston, VA 24592-2207

Mailing address

PO Box 779
South Boston, VA 24592-0779
Phone (434) 572-8901

Other identifiers 2

IdentifierTypeStateIssuer
4953185MedicaidVA
323121OtherVABC/BS OF NC

Other names 1

  • BERRY HILL NURSING HOME Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other Ability Network

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120424000014 VA Part A Provider - Skilled Nursing Facility 3678693199 Practice locations: South Boston, VA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1649215252. Details of each certification follow.

Skilled nursing facility certification: CCN 495318

Legal name
BERRY HILL NURSING HOME, INC.
Doing business as
BERRY HILL NURSING HOME
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Mar 27, 1997
Last certification
Aug 22, 2024
Beds
120
Ownership / control type
Corporation
Organization structure
CorporationProprietary
Incorporated
May 12, 1973 in VA
Enrollment address
621 Berry Hill Road
South Boston, VA 24592-2207
Nursing home name
BERRY HILL NURSING HOME

Care Compare: Nursing home

Medicare Care Compare
Listed as
Berry Hill Nursing HomeCCN 495318 · All quality measures
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
Mar 27, 1997
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
12045.9 residents per day on average

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
49D0875865Berry Hill Nursing Home621 Berry Hill Road, South Boston, VA 24592Certificate of waiverSep 1, 2027

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 6

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

NameRoleSinceShare
George Carrolton Stevens Family Trust Organization, Berry Hill, VA 5% Or Greater Direct Ownership Interest Mar 15, 2012 100%
Trustee of the SNF Jan 1, 1977
Adp of the SNF Jan 1, 1977
Gale R Boice Individual Corporate OfficerCfo Mar 5, 2018
C Jason Claiborne Individual Operational/Managerial Control Apr 22, 2022
Adp of the SNF Apr 22, 2025
James Danner Individual Operational/Managerial Control Apr 22, 2022
Adp of the SNF Apr 22, 2025
Principle Long Term Care, Inc. Organization, Kinston, NC Corporation, Management services company Operational/Managerial Control Jan 1, 2011
Mark Stevens Individual Corporate DirectorCfo Jul 1, 1997
Operational/Managerial Control Jul 1, 1977
Trustee of the SNF Jan 1, 1977
Adp of the SNF Jan 1, 1977

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 43

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

View all 43

Practitioners & affiliated clinicians

Affiliated clinicians 1

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": "1150588800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1626220800000",
    "number": "1649215252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 779",
            "city": "SOUTH BOSTON",
            "state": "VA",
            "postal_code": "245920779",
            "telephone_number": "434-572-8901",
            "fax_number": "434-572-8904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "621 BERRY HILL RD",
            "city": "SOUTH BOSTON",
            "state": "VA",
            "postal_code": "245922207",
            "telephone_number": "434-572-8901",
            "fax_number": "434-572-8904"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BERRY HILL NURSING HOME, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-18",
        "last_updated": "2021-07-14",
        "certification_date": "2021-07-14",
        "status": "A",
        "authorized_official_last_name": "BOICE",
        "authorized_official_first_name": "GALE",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "252-523-9094",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "VA",
            "license": "NH2502",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4953185",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS OF NC",
            "identifier": "323121",
            "state": "VA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.667.2",
            "affiliationName": "Ability Network",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "100 N 6th St Ste 900A",
            "city": "Minneapolis",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554031516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "BERRY HILL NURSING HOME",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "BERRY HILL NURSING HOME",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in South Boston, VA

Sources for this page

Verify at the official NPI Registry.