NPIMap

Organization Active NPI

Snowshoe LTC Group, LLC

  • Skilled Nursing Facility
  • Kernersville, NC
National Provider Identifier
1811923931
Registry record updated Jul 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
NH0256 Issued in NC
Legal business name
SNOWSHOE LTC GROUP, LLC
Practice address
728 Piney Grove Rd
Kernersville, NC 27284-2335
Phone
(336) 996-4038
Fax
(336) 996-0644
NPI assigned
Jun 23, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2021

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

Authorized official

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X NH0256 NC Primary

Addresses

Primary practice location

728 Piney Grove Rd
Kernersville, NC 27284-2335

Mailing address

728 Piney Grove Rd
Kernersville, NC 27284-2335
Phone (336) 996-4038

Other identifiers 5

IdentifierTypeStateIssuer
15934OtherNCPARTNERS INSURANCE #
7108231OtherNCUNITED HEALTHCARE #
3405354MedicaidNC
0098COtherNCBC/BS OF NC
3415354MedicaidNC

Other names 1

  • Piney Grove Nursing and Rehabilitation Center 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 NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110413000468 NC Part A Provider - Skilled Nursing Facility 5092996207 Practice locations: Kernersville, NC

Skilled nursing facility certification: CCN 345354

Legal name
SNOWSHOE LTC GROUP, LLC
Doing business as
PINEY GROVE NURSING AND REHABILITATION CENTER
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Mar 7, 1991
Last certification
Oct 14, 2024
Beds
92
Ownership / control type
Limited Liability Corporation
Multi-facility organization
Principle LTC
Organization structure
LLCProprietary
Incorporated
Aug 20, 2010 in NC
Enrollment address
728 Piney Grove Road
Kernersville, NC 27284-2335
Nursing home name
PINEY GROVE NURSING AND REHABILITATION CENTER
Affiliated entity
PRINCIPLE LONG TERM CARE

Other NPIs with the same Medicare PAC ID 4

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Nursing home

Medicare Care Compare
Listed as
Piney Grove Nursing and Rehabilitation CenterCCN 345354
Overall star rating
3 of 5
Health inspections
3 of 5
Staffing
3 of 5
Quality measures
3 of 5
Type
Medicare and Medicaid
Ownership
For profit - Limited Liability company
Certified
Mar 7, 1991
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
9286.8 residents per day on average
Chain
Principle Long Term Care40 facilities in the chain
Penalties (3 years)
3Fines totaling $10,699

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
34D0861928Snowshoe LTC, LLC728 Piney Grove Rd, Kernersville, NC 27284Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory
Tax ID family
Britthaven of Tarboro46 organizations share this tax ID, including this one

Other organizations with this tax ID 45

Organizations that report the same tax identification number in the National Provider Directory.

View all 45

Ownership & related parties

All disclosed owners & managing parties 9

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

NameRoleSinceShare
Raymond Gregg Hill Individual 5% Or Greater Indirect Ownership InterestOwner/Board Member Jan 1, 2011 18.47%
Adp of the SNF Jan 1, 2011
Jared Stimpson Individual Operational/Managerial Control Aug 5, 2024
Adp of the SNF Jul 3, 2025
Robert O'Neil Hill Individual 5% Or Greater Indirect Ownership InterestOwner/Board Member Jan 1, 2011 20.6%
Adp of the SNF Jan 1, 2011
Stephen Britt Hill Individual 5% Or Greater Indirect Ownership InterestOwner/Board Member Jan 1, 2011 20.02%
Adp of the SNF Jan 1, 2011
Gale R Boice Individual Corporate OfficerCfo Mar 5, 2018
Adp of the SNF Mar 5, 2018
Dianne Johnson Individual Corporate OfficerTreasurer Jan 1, 2011
Principle Long Term Care, Inc. Organization, Kinston, NC Management services company, For-profit, Chain home office 5% Or Greater Direct Ownership Interest Jan 1, 2011 50%
Operational/Managerial Control Jan 1, 2011
Ashley Pierce Individual Adp of the SNF Sep 3, 2024
Principle It Services, Inc. Organization, Kinston, NC Corporation, For-profit 5% Or Greater Direct Ownership Interest Jan 28, 2011 50%

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

Practitioners 2

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

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": "1151020800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1625788800000",
    "number": "1811923931",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "728 PINEY GROVE RD",
            "city": "KERNERSVILLE",
            "state": "NC",
            "postal_code": "272842335",
            "telephone_number": "336-996-4038",
            "fax_number": "336-996-0644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "728 PINEY GROVE RD",
            "city": "KERNERSVILLE",
            "state": "NC",
            "postal_code": "272842335",
            "telephone_number": "336-996-4038",
            "fax_number": "336-996-0644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SNOWSHOE LTC GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-23",
        "last_updated": "2021-07-09",
        "certification_date": "2021-07-09",
        "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"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NC",
            "license": "NH0256",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PARTNERS INSURANCE #",
            "identifier": "15934",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE #",
            "identifier": "7108231",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3405354",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS OF NC",
            "identifier": "0098C",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3415354",
            "state": "NC"
        }
    ],
    "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": "Piney Grove Nursing and Rehabilitation Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Piney Grove Nursing and Rehabilitation Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Kernersville, NC

Sources for this page

Verify at the official NPI Registry.