NPIMap

Organization Active NPI

Williamsport South Operations LLC

  • Skilled Nursing Facility
  • Williamsport, PA
National Provider Identifier
1760068381
Registry record updated Dec 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
WILLIAMSPORT SOUTH OPERATIONS LLC
Practice address
101 Leader Dr
Williamsport, PA 17701-1942
Phone
(570) 323-3758
Fax
(570) 323-9228
NPI assigned
Mar 23, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2022

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

Authorized official

Name
Jacob J Zahler
Title
Authorized Member
Phone
(908) 912-2700

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

101 Leader Dr
Williamsport, PA 17701-1942

Mailing address

101 Leader Dr
Williamsport, PA 17701-1942
Phone (570) 323-3758

Other identifiers 1

IdentifierTypeStateIssuer
103891927-0001MedicaidPA

Other names 1

  • Williamsport South Rehabilitation and Nursing Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210914002632 PA Part A Provider - Skilled Nursing Facility 0446656540 Practice locations: Williamsport, PA

Skilled nursing facility certification: CCN 395396

Legal name
WILLIAMSPORT SOUTH OPERATIONS LLC
Doing business as
WILLIAMSPORT SOUTH REHABILITATION AND NURSING CENTER
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Nov 1, 1977
Last certification
Jan 24, 2025
Beds
116
Ownership / control type
Limited Liability Corporation
Organization structure
LLCProprietary
Incorporated
Mar 11, 2021 in PA
Enrollment address
101 Leader Dr
Williamsport, PA 17701-1942

Care Compare: Nursing home

Medicare Care Compare
Listed as
Edenbrook SouthCCN 395396
Overall star rating
1 of 5
Health inspections
1 of 5
Staffing
2 of 5
Quality measures
2 of 5
Type
Medicare and Medicaid
Ownership
For profit - Limited Liability company
Certified
Nov 1, 1977
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
11686.8 residents per day on average
Penalties (3 years)
1Fines totaling $10,824

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 2

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

NameRoleSinceShare
LZ PA Holdings LLC Organization, Monsey, NY Created for acquisition, LLC, Owned by another organization or individual 5% Or Greater Direct Ownership Interest May 31, 2021 100%
Jacob J Zahler Individual 5% Or Greater Indirect Ownership Interest May 31, 2021 100%
Operational/Managerial Control Oct 10, 2024

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Affiliated clinicians 3

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": "1616457600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1671062400000",
    "number": "1760068381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 LEADER DR",
            "city": "WILLIAMSPORT",
            "state": "PA",
            "postal_code": "177011942",
            "telephone_number": "570-323-3758",
            "fax_number": "570-323-9228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 LEADER DR",
            "city": "WILLIAMSPORT",
            "state": "PA",
            "postal_code": "177011942",
            "telephone_number": "570-323-3758",
            "fax_number": "570-323-9228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLIAMSPORT SOUTH OPERATIONS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-23",
        "last_updated": "2022-12-15",
        "certification_date": "2022-12-15",
        "status": "A",
        "authorized_official_last_name": "ZAHLER",
        "authorized_official_first_name": "JACOB",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "AUTHORIZED MEMBER",
        "authorized_official_telephone_number": "908-912-2700"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "103891927-0001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Williamsport South Rehabilitation and Nursing Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Williamsport South Rehabilitation and Nursing Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Williamsport, PA

Sources for this page

Verify at the official NPI Registry.