NPIMap

Organization Active NPI

Marianna Rehabilitation Center, LLC

  • Skilled Nursing Facility
  • Marianna, FL
National Provider Identifier
1710795877
Registry record updated Dec 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
MARIANNA REHABILITATION CENTER, LLC
Practice address
4295 5TH Ave
Marianna, FL 32446-2176
Phone
(850) 482-8091
NPI assigned
Dec 20, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2024

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

Authorized official

Name
Mr. Donald Keith Melton II
Title
Cfo
Phone
(407) 215-8610

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

4295 5TH Ave
Marianna, FL 32446-2176

Mailing address

4295 5TH Ave
Marianna, FL 32446-2176

Other names 1

  • Marianna Health and Rehabilitation Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250129000199 FL Part A Provider - Skilled Nursing Facility 0244769719 Practice locations: Marianna, FL

Skilled nursing facility certification: CCN 105637

Legal name
MARIANNA REHABILITATION CENTER, LLC
Doing business as
MARIANNA HEALTH AND REHABILITATION
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Mar 2, 1989
Last certification
Jan 30, 2025
Beds
180
Ownership / control type
Corporation
Multi-facility organization
Southern Health Care Management
Organization structure
LLCProprietary
Enrollment address
4295 5TH Ave
Marianna, FL 32446-2176
Nursing home name
MARIANNA HEALTH AND REHABILITATION
Affiliated entity
SOVEREIGN HEALTHCARE HOLDINGS

Care Compare: Nursing home

Medicare Care Compare
Listed as
Marianna Health and RehabilitationCCN 105637
Overall star rating
5 of 5
Health inspections
5 of 5
Staffing
4 of 5
Quality measures
4 of 5
Type
Medicare and Medicaid
Ownership
For profit - Corporation
Certified
Mar 2, 1989
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
180144.0 residents per day on average
Chain
Sovereign Healthcare Holdings43 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 18

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

NameRoleSinceShare
Susan Kaar Individual Managing Control - Governing BodyVP of Compliance and Quality MGMT Feb 1, 2025
Adp of the SNF Feb 1, 2025
Sovereign Healthcare Disbursements LLC Organization, Casselberry, FL LLC Adp of the SNF Feb 1, 2025
Fate Brown Individual Managing Control - Governing BodyVice President of Operations Feb 1, 2025
Adp of the SNF Feb 1, 2025
John Mangine Individual Operational/Managerial Control Feb 1, 2025
Adp of the SNF Feb 1, 2025
Indirect Ownership Interest Feb 1, 2025 3%
Southern Healthcare Management LLC Organization, Casselberry, FL LLC, Management services company Operational/Managerial Control Feb 1, 2025
Adp of the SNF Jan 16, 2026
Michelle Kelly Individual Adp of the SNF Feb 1, 2025
Donald K Melton Individual Operational/Managerial Control Feb 1, 2025
Adp of the SNF Feb 1, 2025
William Notermann Individual Operational/Managerial Control Feb 1, 2025
Adp of the SNF Feb 1, 2025
Dustin Cole Dryden Individual Operational/Managerial Control Feb 1, 2025
Adp of the SNF Feb 1, 2025
Sovereign Healthcare Holdings LLC Organization, Atlanta, GA LLC, Holding company, Chain home office, Owned by another organization or individual Direct Ownership Interest Feb 1, 2025 100%
HSP West Florida LLC Organization, Casselberry, FL LLC, Owned by another organization or individual 5% Or Greater Security Interest Feb 1, 2025 100%
Adp of the SNF Feb 1, 2025
Royce M Cronquist Individual Operational/Managerial Control Feb 1, 2025
Adp of the SNF Feb 1, 2025
John a Spence Individual Operational/Managerial Control Feb 1, 2025
Adp of the SNF Feb 1, 2025
John J Notermann Business TR Organization, Casselberry, FL Indirect Ownership Interest Nov 12, 2017 82.5%
Forvis Mazars LLP Organization, Springfield, MO Adp of the SNF Feb 1, 2025
Dawn Chery Individual Managing Control - Governing BodyChief Nursing Officer Feb 1, 2025
Adp of the SNF Feb 1, 2025
Cronquist 2015 Family TR Organization, Atlanta, GA Indirect Ownership Interest Feb 1, 2025 14.5%
Regions Bank Organization, Birmingham, AL Financial institution 5% Or Greater Security Interest Feb 1, 2025 100%

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 41

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

View all 41

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": "1734652800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1734652800000",
    "number": "1710795877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4295 5TH AVE",
            "city": "MARIANNA",
            "state": "FL",
            "postal_code": "324462176"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4295 5TH AVE",
            "city": "MARIANNA",
            "state": "FL",
            "postal_code": "324462176",
            "telephone_number": "850-482-8091"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARIANNA REHABILITATION CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-12-20",
        "last_updated": "2024-12-20",
        "certification_date": "2024-12-20",
        "status": "A",
        "authorized_official_last_name": "MELTON",
        "authorized_official_first_name": "DONALD",
        "authorized_official_middle_name": "KEITH",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "407-215-8610",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "II"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Marianna Health and Rehabilitation",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Marianna, FL

Sources for this page

Verify at the official NPI Registry.