Active NPI
Chestnut Ridge Cypress LLC
Doing business as Chestnut Ridge Nursing and Rehabilitation Center
- Skilled Nursing Facility
- Cumming, GA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- Legal business name
- CHESTNUT RIDGE CYPRESS LLC
- Doing business as
- Chestnut Ridge Nursing and Rehabilitation Center
- Practice address
- 125 Samaritan Dr
Cumming, GA 30040-2354 - Phone
- (770) 889-0120
- NPI assigned
- Dec 18, 2013
- Last updated
- Jan 19, 2022
- Organization subpart
- Yes
- Parent organization
- CYPRESS SKILLED NURSING LLC
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Isaac Y Ovits
- Title
- Cfo
- Phone
- (845) 694-6055
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | Primary |
Addresses
Primary practice location
125 Samaritan Dr
Cumming, GA 30040-2354
Mailing address
125 Samaritan Dr
Cumming, GA 30040-2354
Phone (770) 889-0120
Other names 1
- Chestnut Ridge Nursing and Rehabilitation Center
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20140317000319 | GA | Part A Provider - Skilled Nursing Facility | 9638300684 | Practice locations: Cumming, GA |
NPI to CCN mapping 1
The Medicare certification numbers (CCNs) connected to NPI 1982025920. Details of each certification follow.
Skilled nursing facility certification: CCN 115423
- Legal name
- CHESTNUT RIDGE CYPRESS LLC
- Doing business as
- CHESTNUT RIDGE NURSING AND REHABILITATION CENTER
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Jul 1, 1989
- Last certification
- Feb 2, 2025
- Beds
- 150
- Ownership / control type
- Limited Liability Corporation
- Multi-facility organization
- CYPRESS SKILLED NURSING
- Organization structure
- LLC
- Enrollment address
- 125 Samaritan Dr
Cumming, GA 30040-2354 - Nursing home name
- CHESTNUT RIDGE NSG & REHAB CTR
- Affiliated entity
- CYPRESS SKILLED NURSING
Care Compare: Nursing home
Medicare Care Compare- Listed as
- Chestnut Ridge NSG & Rehab Ctr
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- For profit - Limited Liability company
- Certified
- Jul 1, 1989
- Medicare certification status
- Active
- Certified beds
- 150
- Chain
- Cypress Skilled Nursing
National Provider Directory
National Provider Directory- Tax ID family
- CHC - Chestnut Ridge Nursing Rehab Ctr LLC
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
dba Chestnut Ridge Nursing & Rehab Center
- Skilled Nursing Facility
- Cumming, GA
- NPI 1801892070
Ownership & related parties
All disclosed owners & managing parties 20
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 |
|---|---|---|---|
| Cypress Skilled Nursing LLC | 5% Or Greater Direct Ownership Interest | Nov 12, 2013 | 100% |
| Operational/Managerial Control | Jan 1, 2014 | ||
| Adp of the SNF | Nov 18, 2025 | ||
| Sara Bender | Operational/Managerial Control | Jul 2, 2025 | |
| Adp of the SNF | Jul 2, 2025 | ||
| Cypress Operating LLC | 5% Or Greater Indirect Ownership Interest | Nov 12, 2013 | 100% |
| Adp of the SNF | Apr 1, 2024 | ||
| SNF TR | Indirect Ownership Interest | Nov 12, 2013 | 50% |
| Timothy Patterson | Operational/Managerial Control | Sep 6, 2022 | |
| Adp of the SNF | Sep 6, 2022 | ||
| Brent Moss | Operational/Managerial Control | Mar 5, 2025 | |
| Adp of the SNF | Mar 5, 2025 | ||
| Elizabeth Nardiello | Operational/Managerial Control | Mar 11, 2018 | |
| Adp of the SNF | Mar 11, 2018 | ||
| Isaac Y Ovits | Operational/Managerial Control | Jan 1, 2014 | |
| Managing Control - Governing Body | Jan 1, 2014 | ||
| Adp of the SNF | Jan 1, 2014 | ||
| Maria Macatula | Operational/Managerial Control | Jul 31, 2017 | |
| Adp of the SNF | Jul 31, 2017 | ||
| Michael Whipple | Operational/Managerial Control | Jan 8, 2001 | |
| Adp of the SNF | Jan 8, 2001 | ||
| Karen Phillip | Operational/Managerial Control | Jul 21, 2024 | |
| Adp of the SNF | Jul 21, 2024 | ||
| Dianne W Patterson | Operational/Managerial Control | May 7, 2018 | |
| Managing Control - Governing Body | May 7, 2018 | ||
| Adp of the SNF | May 7, 2018 | ||
| Faizan Shaikh | Operational/Managerial Control | Jun 6, 2025 | |
| Adp of the SNF | Jun 6, 2025 | ||
| Adp of the SNF | Aug 7, 2017 | ||
| Adp of the SNF | Dec 22, 2014 | ||
| Enin TR | Indirect Ownership Interest | Nov 12, 2013 | 50% |
| Adp of the SNF | Nov 18, 2025 | ||
| Adp of the SNF | Jun 17, 2025 | ||
| Katherine L Nordholm | Operational/Managerial Control | Jan 1, 2014 | |
| Adp of the SNF | Jan 1, 2014 |
Owners & managing parties with NPI records 1
Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.
-
- Internal Medicine Physician
- Atlanta, GA
- NPI 1376904292
Adp of the SNF, Operational/Managerial Control
Facilities with the same owner 6
Facilities that share an organizational owner with 5% or greater ownership or operational control.
-
dba Carrollton Nursing and Rehabilitation Center
- Skilled Nursing Facility
- Carrollton, GA
- NPI 1891116836
Cypress Operating LLC, Cypress Skilled Nursing LLC
-
dba Cedar Valley Nursing and Rehabilitation Center
- Skilled Nursing Facility
- Cedartown, GA
- NPI 1346661386
Cypress Skilled Nursing LLC
-
dba Haralson Nursing and Rehabilitation Center
- Skilled Nursing Facility
- Bremen, GA
- NPI 1356762322
Cypress Operating LLC, Cypress Skilled Nursing LLC
-
dba Pine Knoll Nursing and Rehabilitation Center
- Skilled Nursing Facility
- Carrollton, GA
- NPI 1255752226
Cypress Operating LLC, Cypress Skilled Nursing LLC
-
dba Social Circle Nursing and Rehabilitation Center
- Skilled Nursing Facility
- Social Circle, GA
- NPI 1780005751
Cypress Operating LLC, Cypress Skilled Nursing LLC
-
dba University Nursing and Rehabilitation Center
- Skilled Nursing Facility
- Athens, GA
- NPI 1497176465
Cypress Operating LLC, Cypress Skilled Nursing LLC
Practitioners & affiliated clinicians
Practitioners 3
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.
-
- Internal Medicine Physician
- Cumming, GA
- NPI 1588690879
-
- Geriatric Medicine (Family Medicine) Physician
- Alpharetta, GA
- NPI 1295774305
-
- Internal Medicine Physician
- Atlanta, GA
- NPI 1376904292
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1387324800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1642550400000",
"number": "1982025920",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "125 SAMARITAN DR",
"city": "CUMMING",
"state": "GA",
"postal_code": "300402354",
"telephone_number": "770-889-0120"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "125 SAMARITAN DR",
"city": "CUMMING",
"state": "GA",
"postal_code": "300402354",
"telephone_number": "770-889-0120"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "CHESTNUT RIDGE CYPRESS LLC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "CYPRESS SKILLED NURSING LLC",
"enumeration_date": "2013-12-18",
"last_updated": "2022-01-19",
"certification_date": "2022-01-19",
"status": "A",
"authorized_official_last_name": "OVITS",
"authorized_official_first_name": "ISAAC",
"authorized_official_middle_name": "Y",
"authorized_official_title_or_position": "CFO",
"authorized_official_telephone_number": "845-694-6055"
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Chestnut Ridge Nursing and Rehabilitation Center",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Chestnut Ridge Nursing and Rehabilitation Center",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Cumming, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2022; 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.