Active NPI
Vanguard of Ripley, LLC
- Skilled Nursing Facility
- Ripley, MS
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- License
- 337
- Legal business name
- VANGUARD OF RIPLEY, LLC
- Practice address
- 103 Cunningham Dr
Ripley, MS 38663 - Phone
- (662) 837-3062
- Fax
- (662) 837-1395
- NPI assigned
- Jan 13, 2006
- Organization subpart
- Yes
- Parent organization
- VANGUARD HEALTHCARE, LLC
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. William D. Orand
- Title
- Ceo
- Phone
- (615) 250-7100
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | 337 | MS | Primary |
Addresses
Primary practice location
103 Cunningham Dr
Ripley, MS 38663
Mailing address
9020 Overlook Blvd Ste 202
Brentwood, TN 37027-2755
Phone (615) 250-7100
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00230095 | Medicaid | MS |
Other names 1
- Rest Haven Health and Rehabilitation
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MS
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20080211000441 | MS | Part A Provider - Skilled Nursing Facility | 1658454905 | Practice locations: Ripley, MS |
Skilled nursing facility certification: CCN 255247
- Legal name
- VANGUARD OF RIPLEY, LLC
- Doing business as
- RESTHAVEN HEALTH AND REHABILITATION
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Jun 1, 1997
- Last certification
- Apr 25, 2024
- Beds
- 60
- Ownership / control type
- Corporation
- Multi-facility organization
- Vanguard Healthcare
- Organization structure
- LLC
- Incorporated
- Nov 20, 1998 in TN
- Enrollment address
- 103 Cunningham Dr
Resthaven Health & Rehabilitation
Ripley, MS 38663-1302 - Nursing home name
- REST HAVEN HEALTH AND REHABILITATION
- Affiliated entity
- VANGUARD HEALTHCARE
Care Compare: Nursing home
Medicare Care Compare- Listed as
- Rest Haven Health and Rehabilitation
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- For profit - Corporation
- Certified
- Jun 1, 1997
- Medicare certification status
- Active
- Certified beds
- 60
- Chain
- Vanguard Healthcare
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 25D0316564 | Vanguard of Ripley LLC | Certificate of waiver | Aug 31, 2026 |
National Provider Directory
National Provider DirectoryOwnership & related parties
All disclosed owners & managing parties 11
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 |
|---|---|---|---|
| Jere Suzanne Ervin Irrv TR | 5% Or Greater Indirect Ownership Interest | Dec 19, 2007 | 16% |
| Vanguard Healthcare, LLC | 5% Or Greater Direct Ownership Interest | Dec 19, 2007 | 100% |
| John T Fick | Corporate Officer | Sep 20, 2014 | |
| Capital One NA | 5% Or Greater Mortgage Interest | Jan 31, 2018 | 100% |
| Orand LP | 5% Or Greater Indirect Ownership Interest | Dec 19, 2007 | 6% |
| Nicola Harrison | Other | Jan 31, 2018 | |
| Alexander Wright | W-2 Managing Employee | Feb 23, 2015 | |
| Ervin General Partnership | 5% Or Greater Indirect Ownership Interest | Dec 19, 2007 | 40% |
| North Mississippi Management Associates, LLC | Operational/Managerial Control | Dec 19, 2007 | 100% |
| William Jeffrey Ervin Irrv TR | 5% Or Greater Indirect Ownership Interest | Dec 19, 2007 | 16% |
| William D Orand | 5% Or Greater Indirect Ownership Interest | Dec 19, 2007 | 54% |
| Corporate Officer | Dec 19, 2007 | ||
| Corporate Director | Dec 19, 2007 |
Facilities with the same owner 4
Facilities that share an organizational owner with 5% or greater ownership or operational control.
-
- Skilled Nursing Facility
- Columbus, MS
- NPI 1811976368
Ervin General Partnership, Jere Suzanne Ervin Irrv TR, North Mississippi Management Associates, LLC, Orand LP, Vanguard Healthcare, LLC, William Jeffrey Ervin Irrv TR
-
- Skilled Nursing Facility
- Vicksburg, MS
- NPI 1972001493
Ervin General Partnership, Jere Suzanne Ervin Irrv TR, Orand LP, Vanguard Healthcare, LLC, William Jeffrey Ervin Irrv TR
-
- Skilled Nursing Facility
- Ashland, MS
- NPI 1609855154
Ervin General Partnership, Jere Suzanne Ervin Irrv TR, North Mississippi Management Associates, LLC, Orand LP, Vanguard Healthcare, LLC, William Jeffrey Ervin Irrv TR
-
- Skilled Nursing Facility
- Vicksburg, MS
- NPI 1578553459
Ervin General Partnership, Jere Suzanne Ervin Irrv TR, Orand LP, Vanguard Healthcare, LLC, William Jeffrey Ervin Irrv TR
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Family Medicine Physician
- New Albany, MS
- NPI 1790751469
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": "1137110400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1527120000000",
"number": "1922087352",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9020 OVERLOOK BLVD STE 202",
"city": "BRENTWOOD",
"state": "TN",
"postal_code": "370272755",
"telephone_number": "615-250-7100",
"fax_number": "615-250-7101"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "103 CUNNINGHAM DR",
"city": "RIPLEY",
"state": "MS",
"postal_code": "38663",
"telephone_number": "662-837-3062",
"fax_number": "662-837-1395"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "VANGUARD OF RIPLEY, LLC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "VANGUARD HEALTHCARE, LLC",
"enumeration_date": "2006-01-13",
"last_updated": "2018-05-24",
"status": "A",
"authorized_official_last_name": "ORAND",
"authorized_official_first_name": "WILLIAM",
"authorized_official_middle_name": "D.",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "615-250-7100",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": "MS",
"license": "337",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00230095",
"state": "MS"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Rest Haven Health and Rehabilitation",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Rest Haven Health and Rehabilitation",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Ripley, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2018; 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.