NPIMap

Organization Active NPI

Waters of Winchester LLC

  • Skilled Nursing Facility
  • Winchester, TN
National Provider Identifier
1821542879
Registry record updated Mar 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
WATERS OF WINCHESTER LLC
Practice address
1360 Bypass Rd
Winchester, TN 37398-2332
Phone
(931) 967-7082
Fax
(931) 967-0942
NPI assigned
Aug 8, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2023

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

Authorized official

Name
Moishe Gubin
Title
Member
Phone
(708) 449-1900

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

1360 Bypass Rd
Winchester, TN 37398-2332

Mailing address

1360 Bypass Rd
Winchester, TN 37398-2332
Phone (931) 967-7082

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20161109002185 TN Part A Provider - Skilled Nursing Facility 3870872112 Practice locations: Winchester, TN

Skilled nursing facility certification: CCN 445145

Legal name
WATERS OF WINCHESTER LLC
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Jun 22, 1981
Last certification
Jul 12, 2023
Beds
132
Ownership / control type
Corporation
Multi-facility organization
Sweetwater Care
Most recent change of ownership
Sep 1, 2016
Organization structure
LLCProprietary
Enrollment address
1360 Bypass Rd
Winchester, TN 37398-2332
Nursing home name
HERITAGE PLACE CARE & REHABILITATION LLC
Affiliated entity
INFINITY HEALTHCARE CONSULTING

Care Compare: Nursing home

Medicare Care Compare
Listed as
Heritage Place Care & Rehabilitation LLCCCN 445145
Overall star rating
1 of 5
Health inspections
2 of 5
Staffing
1 of 5
Quality measures
4 of 5
Type
Medicare and Medicaid
Ownership
For profit - Corporation
Certified
Jun 22, 1981
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
13279.0 residents per day on average
Chain
Infinity Healthcare Consulting69 facilities in the chain

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
44D0684650Waters of Winchester, the1360 Bypass Road, Winchester, TN 37398Certificate of waiverAug 11, 2027

National Provider Directory

National Provider Directory

Ownership & 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.

NameRoleSinceShare
Gubin Enterprises Limited Partnership Organization, South Bend, IN For-profit 5% Or Greater Direct Ownership Interest Sep 1, 2016 50%
Michael Blisko Individual 5% Or Greater Direct Ownership Interest Sep 1, 2016 50%
John Davis Individual W-2 Managing EmployeeAdministrator Mar 23, 2022

Facilities with the same owner 30

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

View all 30

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": "1470614400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1679443200000",
    "number": "1821542879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1360 BYPASS RD",
            "city": "WINCHESTER",
            "state": "TN",
            "postal_code": "373982332",
            "telephone_number": "931-967-7082",
            "fax_number": "931-967-0942"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1360 BYPASS RD",
            "city": "WINCHESTER",
            "state": "TN",
            "postal_code": "373982332",
            "telephone_number": "931-967-7082",
            "fax_number": "931-967-0942"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WATERS OF WINCHESTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-08",
        "last_updated": "2023-03-22",
        "certification_date": "2023-03-22",
        "status": "A",
        "authorized_official_last_name": "GUBIN",
        "authorized_official_first_name": "MOISHE",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "708-449-1900"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winchester, TN

Sources for this page

Verify at the official NPI Registry.