NPIMap

Organization Active NPI

Botetourt Health Care, LLC

  • Skilled Nursing Facility
  • Daleville, VA
National Provider Identifier
1922039015
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
NH2757 Issued in VA
Legal business name
BOTETOURT HEALTH CARE, LLC
Practice address
290 Commons Pkwy
Daleville, VA 24083-1707
Phone
(540) 966-0056
Fax
(540) 966-2511
NPI assigned
Jul 6, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Marya J Morrison
Title
Cfo
Phone
(727) 723-3000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X NH2757 VA Primary

Addresses

Primary practice location

290 Commons Pkwy
Daleville, VA 24083-1707

Mailing address

290 Commons Pkwy
Daleville, VA 24083-1707
Phone (540) 966-0056

Other names 1

  • CARRINGTON PLACE @ BOTETOURT COMMONS Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20051107000029 VA Part A Provider - Skilled Nursing Facility 5496788408 Practice locations: Daleville, VA

Skilled nursing facility certification: CCN 495386

Legal name
BOTETOURT HEALTH CARE, LLC
Doing business as
CARRINGTON PLACE AT BOTETOURT COMMONS
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Dec 19, 2005
Last certification
Apr 10, 2024
Beds
90
Ownership / control type
Corporation
Multi-facility organization
Ark Pose Acute Care
Organization structure
LLCProprietary
Incorporated
Jun 6, 2005 in VA
Enrollment address
290 Commons Parkway
Daleville, VA 24083-1707

Care Compare: Nursing home

Medicare Care Compare
Listed as
Daleville Health and RehabilitationCCN 495386
Overall star rating
2 of 5
Health inspections
3 of 5
Staffing
1 of 5
Quality measures
4 of 5
Type
Medicare and Medicaid
Ownership
For profit - Corporation
Certified
Dec 19, 2005
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
9084.3 residents per day on average

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 6

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

NameRoleSinceShare
Ark Post Acute Network LLC Organization, Clearwater, FL LLC Operational/Managerial Control Jan 1, 2021 100%
Kimberly a Justiniano Individual Corporate OfficerCfo Mar 1, 2020 25%
Creative Care Resources LLC Organization, Clearwater, FL LLC 5% Or Greater Direct Ownership Interest Mar 31, 2021 20%
VA Botetourt Ops LLC Organization, Clearwater, FL LLC 5% Or Greater Direct Ownership Interest Mar 1, 2020 80%
Brian S Anderson Individual W-2 Managing EmployeeNursing Home Administrator Aug 11, 2021 25%
Roy B Bridges Individual Corporate OfficerCfo Mar 1, 2020 25%

Facilities with the same owner 7

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

Practitioners & affiliated clinicians

Practitioners 1

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

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": "1152144000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1922039015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "290 COMMONS PKWY",
            "city": "DALEVILLE",
            "state": "VA",
            "postal_code": "240831707",
            "telephone_number": "540-966-0056",
            "fax_number": "540-966-2511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "290 COMMONS PKWY",
            "city": "DALEVILLE",
            "state": "VA",
            "postal_code": "240831707",
            "telephone_number": "540-966-0056",
            "fax_number": "540-966-2511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOTETOURT HEALTH CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-06",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MORRISON",
        "authorized_official_first_name": "MARYA",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "727-723-3000"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "VA",
            "license": "NH2757",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CARRINGTON PLACE @ BOTETOURT COMMONS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Daleville, VA

Sources for this page

Verify at the official NPI Registry.