Active NPI
Grant Rehab & Care Center
- Skilled Nursing Facility
- Petersburg, WV
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- License
- 102
- Legal business name
- GRANT REHAB & CARE CENTER
- Practice address
- 127 Early Avenue
Petersburg, WV 26847-9403 - Phone
- (304) 257-4233
- Fax
- (304) 257-4610
- NPI assigned
- Oct 27, 2005
- Last updated
- Mar 3, 2020
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Teresa Halliday
- Title
- Administrator
- Phone
- (304) 257-4233
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | 102 | WV | Primary |
Addresses
Primary practice location
127 Early Avenue
Petersburg, WV 26847-9403
Mailing address
127 Early Avenue
Petersburg, WV 26847-9403
Phone (304) 257-4233
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1065000 | Other | WV | WORKER'S COMPENSATION |
| 0004108000 | Medicaid | WV |
Other names 1
- Grant County Nursing Home
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WV
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20200228000348 | WV | Part A Provider - Skilled Nursing Facility | 5092142281 | Practice locations: Petersburg, WV |
NPI to CCN mapping 1
The Medicare certification numbers (CCNs) connected to NPI 1740270982. Details of each certification follow.
Skilled nursing facility certification: CCN 515151
- Legal name
- GRANT REHAB & CARE CENTER
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Apr 1, 1997
- Last certification
- Apr 17, 2024
- Beds
- 110
- Ownership / control type
- County
- Organization structure
- Corporation
- Incorporated
- Aug 16, 2017 in WV
- Enrollment address
- 127 Early Ave
Petersburg, WV 26847-7500 - Nursing home name
- GRANT REHABILITATION AND CARE CENTER
Care Compare: Nursing home
Medicare Care Compare- Listed as
- Grant Rehabilitation and Care Center
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- Government - County
- Certified
- Apr 1, 1997
- Medicare certification status
- Active
- Certified beds
- 110
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 51D0236985 | Grant County Nursing Home | Certificate of waiver | Aug 31, 2026 |
National Provider Directory
National Provider DirectoryOwnership & related parties
All disclosed owners & managing parties 1
As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.
| Name | Role | Since | Share |
|---|---|---|---|
| Christina Thorne | W-2 Managing Employee | Nov 18, 2019 | 100% |
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.
-
- Family Medicine Physician
- Petersburg, WV
- NPI 1386718484
-
- Family Medicine Physician
- Moorefield, WV
- NPI 1831163500
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": "1130371200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1583193600000",
"number": "1740270982",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "127 EARLY AVENUE",
"city": "PETERSBURG",
"state": "WV",
"postal_code": "268479403",
"telephone_number": "304-257-4233",
"fax_number": "304-257-4610"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "127 EARLY AVENUE",
"city": "PETERSBURG",
"state": "WV",
"postal_code": "268479403",
"telephone_number": "304-257-4233",
"fax_number": "304-257-4610"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "GRANT REHAB & CARE CENTER",
"organizational_subpart": "NO",
"enumeration_date": "2005-10-27",
"last_updated": "2020-03-03",
"certification_date": "2020-03-03",
"status": "A",
"authorized_official_last_name": "HALLIDAY",
"authorized_official_first_name": "TERESA",
"authorized_official_title_or_position": "ADMINISTRATOR",
"authorized_official_telephone_number": "304-257-4233"
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": "WV",
"license": "102",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WORKER'S COMPENSATION",
"identifier": "1065000",
"state": "WV"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0004108000",
"state": "WV"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Grant County Nursing Home",
"code": "4",
"type": "Former Legal Business Name"
}
]
}
Other providers in Petersburg, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.