Active NPI
Piney Forest SNF LLC
- Skilled Nursing Facility
- Danville, VA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- Legal business name
- PINEY FOREST SNF LLC
- Doing business as
- Piney Forest Health & Rehabilitation Center
- Practice address
- 450 Piney Forest Rd
Danville, VA 24540-4011 - Phone
- (434) 799-1565
- NPI assigned
- May 13, 2021
- 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
- Kyle Swim
- Title
- Administrator
- Phone
- (434) 799-1565
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | Primary |
Addresses
Primary practice location
450 Piney Forest Rd
Danville, VA 24540-4011
Mailing address
450 Piney Forest Rd
Danville, VA 24540-4011
Other names 1
- Piney Forest Health & Rehabilitation Center
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in VA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20210823003250 | VA | Part A Provider - Skilled Nursing Facility | 8729483102 | Practice locations: Danville, VA |
Skilled nursing facility certification: CCN 495107
- Legal name
- PINEY FOREST SNF LLC
- Doing business as
- PINEY FOREST HEALTH & REHABILITATION CENTER
- Certification status
- Active
- Provider type (POS)
- Nursing home โ SNF/NF dual certification
- Participating since
- Jan 1, 1978
- Last certification
- Jan 30, 2025
- Beds
- 120
- Ownership / control type
- Corporation
- Multi-facility organization
- Medical Facilities of America
- Most recent change of ownership
- May 28, 2021
- Organization structure
- LLC
- Enrollment address
- 450 Piney Forest Rd
Danville, VA 24540-4011 - Nursing home name
- PINEY FOREST HEALTH AND REHABILITATION CENTER
- Affiliated entity
- LIFEWORKS REHAB
Care Compare: Nursing home
Medicare Care Compare- Listed as
- Piney Forest Health and Rehabilitation Center
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- For profit - Corporation
- Certified
- Jan 1, 1978
- Medicare certification status
- Active
- Certified beds
- 120
- Chain
- Lifeworks Rehab
National Provider Directory
National Provider DirectoryOwnership & related parties
All disclosed owners & managing parties 19
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 |
|---|---|---|---|
| Lauren 2020 LLC | 5% Or Greater Indirect Ownership Interest | May 28, 2021 | 23.75% |
| Springrock South LLC | 5% Or Greater Indirect Ownership Interest | May 28, 2021 | 75% |
| Norman 5571 & Family LLC | 5% Or Greater Indirect Ownership Interest | May 28, 2021 | 23.75% |
| RL 2008 Family Trust | 5% Or Greater Indirect Ownership Interest | May 28, 2021 | 10% |
| Charles 1994 Family Grantor Trust | 5% Or Greater Indirect Ownership Interest | May 28, 2021 | 21.37% |
| Lauren 2020 Family Grantor Trust | 5% Or Greater Indirect Ownership Interest | May 28, 2021 | 22.56% |
| Piney Forest Holdings I LLC | 5% Or Greater Direct Ownership Interest | May 28, 2021 | 100% |
| Rsbrm South Manager LLC | Operational/Managerial Control | May 28, 2021 | 100% |
| Norman 5571 Family Grantor Trust | 5% Or Greater Indirect Ownership Interest | May 28, 2021 | 21.37% |
| Norman 5571 LLC | 5% Or Greater Indirect Ownership Interest | May 28, 2021 | 22.49% |
| Saul 2012 Family Grantor Trust | 5% Or Greater Indirect Ownership Interest | May 28, 2021 | 22.56% |
| Leps 2003 Family Trust | 5% Or Greater Indirect Ownership Interest | May 28, 2021 | 10% |
| Amber K Tejeda | Corporate Officer | Jan 23, 2024 | |
| W-2 Managing Employee | Jan 23, 2024 | ||
| DRM South LLC | 5% Or Greater Indirect Ownership Interest | May 28, 2021 | 25% |
| Robin 2008 LLC | 5% Or Greater Indirect Ownership Interest | May 28, 2021 | 23.75% |
| CK 2008 Family Trust | 5% Or Greater Indirect Ownership Interest | May 28, 2021 | 5% |
| Edward 1998 Family Grantor Trust | 5% Or Greater Indirect Ownership Interest | May 28, 2021 | 22.56% |
| Robin 2008 Family Grantor Trust | 5% Or Greater Indirect Ownership Interest | May 28, 2021 | 22.56% |
| Summer South LLC | 5% Or Greater Indirect Ownership Interest | May 28, 2021 | 100% |
Facilities with the same owner 37
Facilities that share an organizational owner with 5% or greater ownership or operational control.
-
- Skilled Nursing Facility
- Charlottesville, VA
- NPI 1003490277
Charles 1994 Family Grantor Trust, Edward 1998 Family Grantor Trust, Saul 2012 Family Grantor Trust
-
- Skilled Nursing Facility
- Appomattox, VA
- NPI 1639753809
Charles 1994 Family Grantor Trust, Edward 1998 Family Grantor Trust, Saul 2012 Family Grantor Trust
-
- Skilled Nursing Facility
- Virginia Beach, VA
- NPI 1528642790
Charles 1994 Family Grantor Trust, Edward 1998 Family Grantor Trust
-
- Skilled Nursing Facility
- Richmond, VA
- NPI 1508440785
Charles 1994 Family Grantor Trust, Edward 1998 Family Grantor Trust, Saul 2012 Family Grantor Trust
-
- Skilled Nursing Facility
- Vinton, VA
- NPI 1861076044
Charles 1994 Family Grantor Trust, Edward 1998 Family Grantor Trust, Saul 2012 Family Grantor Trust
-
- Skilled Nursing Facility
- Bowling Green, VA
- NPI 1619551801
Charles 1994 Family Grantor Trust, Edward 1998 Family Grantor Trust, Saul 2012 Family Grantor Trust
-
- Skilled Nursing Facility
- Burke, VA
- NPI 1861076051
Charles 1994 Family Grantor Trust, Edward 1998 Family Grantor Trust, Saul 2012 Family Grantor Trust
-
- Skilled Nursing Facility
- Charlottesville, VA
- NPI 1487238671
Charles 1994 Family Grantor Trust, Edward 1998 Family Grantor Trust, Saul 2012 Family Grantor Trust
-
- Skilled Nursing Facility
- Chesapeake, VA
- NPI 1649854837
Charles 1994 Family Grantor Trust, Edward 1998 Family Grantor Trust, Saul 2012 Family Grantor Trust
-
- Skilled Nursing Facility
- Culpeper, VA
- NPI 1265016455
Charles 1994 Family Grantor Trust, Edward 1998 Family Grantor Trust, Saul 2012 Family Grantor Trust
-
- Skilled Nursing Facility
- Fairfax, VA
- NPI 1033718382
Charles 1994 Family Grantor Trust, Edward 1998 Family Grantor Trust, Saul 2012 Family Grantor Trust
-
- Skilled Nursing Facility
- Rocky Mount, VA
- NPI 1154905354
Charles 1994 Family Grantor Trust, Edward 1998 Family Grantor Trust, Saul 2012 Family Grantor Trust
Practitioners & affiliated clinicians
Affiliated clinicians 1
Clinicians who list this facility as an affiliation in Medicare Care Compare.
-
- Internal Medicine Physician
- Winston Salem, NC
- NPI 1295806750
Nursing home
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1620864000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1620864000000",
"number": "1881268050",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "450 PINEY FOREST RD",
"city": "DANVILLE",
"state": "VA",
"postal_code": "245404011"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "450 PINEY FOREST RD",
"city": "DANVILLE",
"state": "VA",
"postal_code": "245404011",
"telephone_number": "434-799-1565"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PINEY FOREST SNF LLC",
"organizational_subpart": "NO",
"enumeration_date": "2021-05-13",
"last_updated": "2021-05-13",
"certification_date": "2021-05-13",
"status": "A",
"authorized_official_last_name": "SWIM",
"authorized_official_first_name": "KYLE",
"authorized_official_title_or_position": "ADMINISTRATOR",
"authorized_official_telephone_number": "434-799-1565"
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Piney Forest Health & Rehabilitation Center",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Danville, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2021; 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.