Active NPI
Gardner Heights Health Care Center
- Skilled Nursing Facility
- Shelton, CT
National Provider Identifier
1891725008
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- License
- 2296-C
- Legal business name
- GARDNER HEIGHTS HEALTH CARE CENTER
- Practice address
- 172 Rocky Rest Rd
Shelton, CT 06484 - Phone
- (203) 929-1481
- Fax
- (203) 929-9468
- NPI assigned
- Jul 4, 2006
- 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
- Mr. Mark Hambley
- Title
- Cfo
- Phone
- (860) 678-9755
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | 2296-C | CT | Primary |
Addresses
Primary practice location
172 Rocky Rest Rd
Shelton, CT 06484
Mailing address
172 Rocky Rest Rd
Shelton, CT 06484
Phone (203) 929-1481
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CT
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20041221000183 | CT | Part A Provider - Skilled Nursing Facility | 6608834874 | Practice locations: Shelton, CT |
Skilled nursing facility certification: CCN 075368
- Legal name
- GARDNER HEIGHTS HEALTH CARE CENTER
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Jan 1, 1992
- Last certification
- Aug 19, 2024
- Beds
- 130
- Ownership / control type
- Corporation
- Multi-facility organization
- APPLE REHAB
- Most recent change of ownership
- Nov 1, 2004
- Organization structure
- Corporation
- Incorporated
- Sep 28, 2004 in CT
- Enrollment address
- 172 Rocky Rest Rd
Shelton, CT 06484-4299 - Nursing home name
- GARDNER HEIGHTS HEALTH CARE CENTER, INC
- Affiliated entity
- APPLE REHAB
Care Compare: Nursing home
Medicare Care Compare- Listed as
- Gardner Heights Health Care Center, Inc
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- For profit - Corporation
- Certified
- Jan 1, 1992
- Medicare certification status
- Active
- Certified beds
- 124
- Chain
- Apple Rehab
- Penalties (3 years)
- 2
National Provider Directory
National Provider Directory- Tax ID family
- Gardner Heights Health Care Center
Other organizations with this tax ID 2
Organizations that report the same tax identification number in the National Provider Directory.
-
- Skilled Nursing Facility
- Shelton, CT
- NPI 1942221577
-
- Nursing Facility/Intermediate Care Facility
- Shelton, CT
- NPI 1194833731
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.
| Name | Role | Since | Share |
|---|---|---|---|
| Devika Singh | Other | Sep 10, 2018 | |
| Ryan a Vess | Corporate Officer | Mar 15, 2013 | |
| Corporate Director | Mar 15, 2013 | ||
| Operational/Managerial Control | Mar 15, 2013 | ||
| Brian J. Foley | 5% Or Greater Direct Ownership Interest | Nov 1, 2004 | 100% |
| 5% Or Greater Mortgage Interest | Nov 1, 2004 | 100% | |
| Corporate Officer | Nov 1, 2004 | 100% |
Practitioners & affiliated clinicians
Affiliated clinicians 2
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": "1151971200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1891725008",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "172 ROCKY REST RD",
"city": "SHELTON",
"state": "CT",
"postal_code": "06484",
"telephone_number": "203-929-1481",
"fax_number": "203-929-9468"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "172 ROCKY REST RD",
"city": "SHELTON",
"state": "CT",
"postal_code": "06484",
"telephone_number": "203-929-1481",
"fax_number": "203-929-9468"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "GARDNER HEIGHTS HEALTH CARE CENTER",
"organizational_subpart": "NO",
"enumeration_date": "2006-07-04",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "HAMBLEY",
"authorized_official_first_name": "MARK",
"authorized_official_title_or_position": "CFO",
"authorized_official_telephone_number": "860-678-9755",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": "CT",
"license": "2296-C",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Shelton, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.