Porters Chapel Opco, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

PORTERS CHAPEL OPCO, LLC

Practice address

60 Shady Lawn PL
Vicksburg, MS 39180

Phone

(601) 636-1448

Fax

(601) 636-8811

NPI assigned

Jan 30, 2018

Last updated

May 24, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

William D Orand

Title

Ceo

Phone

(615) 250-7100

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MS

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1972001493. Details of each certification follow.

• CCN 255234 Skilled nursing facility · Active · Details

Skilled nursing facility certification: CCN 255234

Legal name

PORTERS CHAPEL OPCO LLC

Doing business as

SHADY LAWN HEALTH AND REHABILITATION

Certification status

Active

Provider type (POS)

Nursing home – SNF/NF dual certification

Participating since

Aug 1, 1996

Last certification

May 2, 2024

Beds

100

Ownership / control type

Corporation

Multi-facility organization

Vanguard Health Services

Organization structure

LLCProprietary

Incorporated

Oct 27, 2017 in TN

Enrollment address

60 Shady Lawn Place
Vicksburg, MS 39180-4588

Nursing home name

SHADY LAWN HEALTH AND REHABILITATION

Affiliated entity

VANGUARD HEALTHCARE

Listed as

Shady Lawn Health and RehabilitationCCN 255234 · All quality measures

Overall star rating

5 of 5

Health inspections

5 of 5

Staffing

5 of 5

Quality measures

3 of 5

Type

Medicare and Medicaid

Ownership

For profit - Corporation

Certified

Aug 1, 1996

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

10076.3 residents per day on average

Chain

Vanguard Healthcare6 facilities in the chain

Processed by Care Compare on Aug 1, 2026.

All disclosed owners & managing parties 13

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

Facilities with the same owner 4

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

• Aurora Australis, LLC

  dba Aurora Health and Rehabilitation

  • Skilled Nursing Facility
  • Columbus, MS
  • NPI 1811976368

  Ervin General Partnership, Jere Suzanne Ervin Irrv TR, Orand LP, Vanguard Healthcare, LLC, William Jeffrey Ervin Irrv TR

  CMS ownership
• Vanguard of Ashland, LLC

  dba Ashland Health and Rehabilitation

  • Skilled Nursing Facility
  • Ashland, MS
  • NPI 1609855154

  Ervin General Partnership, Jere Suzanne Ervin Irrv TR, Orand LP, Vanguard Healthcare, LLC, William Jeffrey Ervin Irrv TR

  CMS ownership
• Vanguard of Ripley, LLC

  dba Rest Haven Health and Rehabilitation

  • Skilled Nursing Facility
  • Ripley, MS
  • NPI 1922087352

  Ervin General Partnership, Jere Suzanne Ervin Irrv TR, Orand LP, Vanguard Healthcare, LLC, William Jeffrey Ervin Irrv TR

  CMS ownership
• Vicksburg Convalescent, LLC

  dba Vicksburg Convalescent Center

  • 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

  CMS ownership

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• John R Barnes, MD

  • Family Medicine Physician
  • Vicksburg, MS
  • NPI 1205865680
  NPD (past)
• Samuel Louis Pierce, M.D.

  • Internal Medicine Physician
  • Jackson, MS
  • NPI 1922237411
  NPD (past)

Affiliated clinicians 4

Clinicians who list this facility as an affiliation in Medicare Care Compare.

• John R Barnes, MD

  • Family Medicine Physician
  • Vicksburg, MS
  • NPI 1205865680

  Nursing home

  Care Compare affiliation
• Joseph W Blackston, MD

  • Internal Medicine Physician
  • Jackson, MS
  • NPI 1194834747

  Nursing home

  Care Compare affiliation
• Robert L Giffin, MD

  • Family Medicine Physician
  • Vicksburg, MS
  • NPI 1376584052

  Nursing home

  Care Compare affiliation
• Samuel Louis Pierce, M.D.

  • Internal Medicine Physician
  • Jackson, MS
  • NPI 1922237411

  Nursing home

  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1517270400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1527120000000",
    "number": "1972001493",
    "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": "60 SHADY LAWN PL",
            "city": "VICKSBURG",
            "state": "MS",
            "postal_code": "39180",
            "telephone_number": "601-636-1448",
            "fax_number": "601-636-8811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PORTERS CHAPEL OPCO, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-30",
        "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"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Madelyn Polk
• Traniecia Polk
• Lapeaches L Pollard
• Ellen Porter
• William C Porter Jr., MD
• Positive Pathways, LLC
• Heather Potts
• Thomas R Potts, CRNA
• David D Powers, PHD
• Shelby Patricia Primeaux, MSN, APRN, AGACNP-BC

• Skilled Nursing Facility in Vicksburg, MS
• Providers in Vicksburg, MS by specialty
• Skilled Nursing Facility in Mississippi

• 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.

Verify at the official NPI Registry.