Active NPI
Kenansville Opco LLC
- Skilled Nursing Facility
- Kenansville, NC
National Provider Identifier
1750004800
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- Legal business name
- KENANSVILLE OPCO LLC
- Practice address
- 209 Beasley St
Kenansville, NC 28349-8727 - Phone
- (908) 506-4204
- NPI assigned
- Sep 23, 2022
- 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
- Tzvi Alter
- Title
- Ceo
- Phone
- (908) 506-4204
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | Primary |
Addresses
Primary practice location
209 Beasley St
Kenansville, NC 28349-8727
Mailing address
311 Blvd of the Americas
Suite 504
Lakewood, NJ 08701
Phone (908) 506-4204
Other names 1
- Kenansville Rehabilitation and Healthcare Center
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NC
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20231212003526 | NC | Part A Provider - Skilled Nursing Facility | 1951763408 | Practice locations: Kenansville, NC |
Skilled nursing facility certification: CCN 345150
- Legal name
- KENANSVILLE OPCO LLC
- Doing business as
- KENANSVILLE REHABILITATION AND HEALTHCARE CENTER
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Nov 29, 1979
- Last certification
- Jun 16, 2025
- Beds
- 92
- Ownership / control type
- Limited Liability Corporation
- Multi-facility organization
- Yad Healthcare
- Most recent change of ownership
- Mar 1, 2023
- Organization structure
- LLC
- Incorporated
- Mar 1, 2023 in NC
- Enrollment address
- 209 Beasley St
Kenansville, NC 28349-8727 - Nursing home name
- KENANSVILLE REHABILITATION AND HEALTHCARE CENTER
- Affiliated entity
- YAD HEALTHCARE
Care Compare: Nursing home
Medicare Care Compare- Listed as
- Kenansville Rehabilitation and Healthcare Center
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- For profit - Limited Liability company
- Certified
- Nov 29, 1979
- Medicare certification status
- Active
- Certified beds
- 92
- Chain
- Yad Healthcare
National Provider Directory
National Provider DirectoryOwnership & related parties
All disclosed owners & managing parties 3
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 |
|---|---|---|---|
| Tzvi Alter | 5% Or Greater Indirect Ownership Interest | Mar 1, 2023 | 99% |
| Corporate Director | Mar 1, 2023 | ||
| Jennifer Hulett | W-2 Managing Employee | Mar 1, 2023 | |
| Kenansville Opco Holdings LLC | 5% Or Greater Direct Ownership Interest | Mar 1, 2023 | 100% |
Practitioners & affiliated clinicians
Practitioners 3
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Internal Medicine Physician
- Raleigh, NC
- NPI 1154429850
-
- Internal Medicine Physician
- Rose Hill, NC
- NPI 1396799334
-
- Family Medicine Physician
- Wilmington, NC
- NPI 1841308277
Affiliated clinicians 3
Clinicians who list this facility as an affiliation in Medicare Care Compare.
-
- Internal Medicine Physician
- Rose Hill, NC
- NPI 1396799334
Nursing home
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1663891200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1663891200000",
"number": "1750004800",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "311 BLVD OF THE AMERICAS",
"address_2": "SUITE 504",
"city": "LAKEWOOD",
"state": "NJ",
"postal_code": "08701",
"telephone_number": "908-506-4204"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "209 BEASLEY ST",
"city": "KENANSVILLE",
"state": "NC",
"postal_code": "283498727",
"telephone_number": "908-506-4204"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "KENANSVILLE OPCO LLC",
"organizational_subpart": "NO",
"enumeration_date": "2022-09-23",
"last_updated": "2022-09-23",
"certification_date": "2022-09-20",
"status": "A",
"authorized_official_last_name": "ALTER",
"authorized_official_first_name": "TZVI",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "908-506-4204"
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Kenansville Rehabilitation and Healthcare Center",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Kenansville, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2022; 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.